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硬通道微创穿刺碎吸术治疗高血压脑出血的临床研究(1)
http://www.100md.com 2018年6月5日 《中国当代医药》 2018年第16期
     [摘要]目的 探讨硬通道微创穿刺碎吸术治疗高血压脑出血的效果。方法 选取2017年1~12月我院收治的64例高血压脑出血患者作为研究对象,按照随机数字表法分为观察组与对照组,每组各32例。患者均予以保守治疗,观察组患者采取硬通道微创穿刺碎吸术,对照组患者采取开颅血肿清除术,比较两组患者的临床疗效、血肿清除率、术前术后神经功能缺损评分、术后并发症发生率。结果 观察组患者治疗后的临床总有效率为90.63%,明显高于对照组的71.88%,差异有统计学意义(P<0.05);观察组患者术后的血肿清除率显著高于对照组(P<0.05);观察组患者术后的神经功能缺损评分显著低于对照组(P<0.05);观察组患者的术后并发症发生率为6.25%,显著低于对照组的31.25%,差异有统计学意义(P<0.05)。结论 硬通道微创穿刺碎吸术治疗高血压脑出血的效果确切,血肿清除彻底,且可明显改善神经功能,减少术后并发症发生率,值得广泛推广和应用。

    [关键词]高血压脑出血;硬通道微创穿刺碎吸术;神经功能缺损评分;并发症

    [中图分类号] R493 [文献标识码] A [文章编号] 1674-4721(2018)6(a)-0069-03

    [Abstract]Objective To investigate the efficacy of minimally invasive puncture and drainage in the treatment of hypertensive intracerebral hemorrhage.Methods From January to December in 2017,64 cases of patients with hypertensive cerebral hemorrhage were selected as the subjects,and divided into observation group and control group by random number table method,32 cases in each group.The patients were treated with conservative treatment.The patients in the observation group were treated by hard channel minimally invasive puncture drainage,and the control group was treated by craniotomy hematoma evacuation.The clinical efficacy,hematoma clearance rate,preoperative and postoperative neurological deficit score and postoperative complication rate of the two groups were compared.Results After treatment,the total clinical effective rate in the observation group was 90.63%,significantly higher than the control group for 71.88%,the difference was statistically significant (P<0.05).Postoperative hematoma clearance rate in the observation group was significantly higher than that in the control group (P<0.05).Postoperative neurological deficit score in the observation group of patients was significantly lower than that in the control group (P<0.05).The postoperative complication rate of the observation group was 6.25%,significantly lower than the control group of 31.25%,the difference was statistically significant (P<0.05).Conclusion Hard channel minimally invasive puncture and drainage is effective in treating hypertensive intracerebral hemorrhage,with a thorough removal of hematoma,and can improve neurological function,reduce postoperative complication rate.Which is worth popularizing and applying widely.

    [Key words]Hypertensive intracerebral hemorrhage;Hard channel minimally invasive puncture and drainage;Neurological deficit score;Complications

    高血压脑出血是神经外科的常见病、多发病,病情危重,致死致残率高。临床保守治疗效果不佳,且后遗症较严重,故目前多采用手术治疗,以及时解除颅内占位,降低颅内压,避免出现脑疝[1-2]。传统多采用开颅手术,但开颅手术时间长,手术过程复杂,清除血肿过程可能又增加了新的脑损伤。硬通道微创穿刺碎吸术是近年来应用较为广泛的一种操作简单的微创手术,本文选取64例高血压脑出血患者作为研究对象,旨在探讨硬通道微创穿刺碎吸术治疗高血压脑出血的效果,現报道如下。, http://www.100md.com(陈苑新 黄鹏 左良成 名强)
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