摘要
[目的]通过应用方体定向置软管血肿排空术与开颅手术救治重型高血压脑出血的临床疗效比较分析,探讨较好的重型高血压脑出血的救治方法。[方法]通过回顾性比较分析,对近4年来随机收治的136例高血压脑出血病例,根据GCS评分(GCS<8分)及按所采用不同的手术方式,随机分成方体定向置管血肿排空术组(微创组),外科开颅手术组(开颅组),每组根据GCS评分又分重、较重、严重三种级别。微创组66例,采用定向置管方法;开颅组70例,采用去骨瓣减压或小骨窗手术法。近期(1个月)和远期随访(6个月)疗效比较。[结果]在重、较重型高血压脑出血救治方面,微创组近期优良率(58.5%)和远期良好率(48.3%)高于开颅组近期优良率(38.6%)和远期良好率(26.8%),P<0.01,差异有显著性意义。而微创组的死亡率(4.6%),明显低于开颅组(15.3%)。[结论]方体定向置软管血肿排空术救治高血压脑出血较开颅手术能明显改善重、较重型高血压脑出血病人预后,降低病人残死率。
[ Objective ] To discover a better method in the treatment of severe hypertensive cerebral hemorrhage through applying cubic oriented stereotactic hematoma aspiration by soft tube indwelling and traditional craniotomy. [ Methods ] To apply a compared retrospective analysis of 136 cases with hypertensive cerebral hemorrhage by random in 4 years, categorized in cubic oriented stereotactic hematoma aspiration group （minimal invasion group）, craniotomy group by GCS scale （GCS 〈 8 ） and their treatment methods. Each group was divided into 3 different levels according to their severity （ severe, fairlysevere, critical）. Sixty -six cases in minimal invasion group were applied with cubic oriented stereotactic aspiration. Seventy cases in craniotomy group were applied with bone flap decompression or small bone window craniotomy. Their outcomes in short term （1 month） and long term （6 month） were compared. [ Results] In level severe and fairly severe, theshort term excellent rate （58.5%） and long.term fineness rate （48.3%） in minimal invasion group were higher than those （ 38.6% and 26.8% ） in craniotomy group （ P 〈 0. 01 ）. Minimal invasion group had a mortality rate （4.6%）, which was obviously lower than that （15.3%） in craniotomy group. [ Conclusion] Cubic oriented stereotactic hematoma aspiration can improve the outcome of patients with severe hypertensive cerebral hemorrhage, and can significantly decrease the mortality and deformity rate.
出处
《大连医科大学学报》
CAS
2009年第4期299-302,共4页
Journal of Dalian Medical University
基金
国家十一五科技支撑计划(2007BA107A13)
关键词
方体定向置管
高血压
脑出血
开颅手术
cubic oriented stereotactic tube indwelling
hypertension
intracerebral hemorrhage
craniotomy
