摘要
目的探析改良颅内血肿微创穿刺清除术治疗小脑出血的可行性及安全性。方法选取广西壮族自治区民族医院(广西医科大学附属民族医院)2012年2月—2014年2月收治的48例小脑出血患者,随机分为观察组和对照组,每组24例。对照组患者采用传统颅内血肿微创穿刺术治疗,观察组患者采用改良颅内血肿微创穿刺清除术(CT定位+术中监测颅内压结合亚低温治疗+术后低位低压引流)治疗。比较两组患者手术穿刺成功率及靶点命中率,术后再出血率及病死率,术后6个月日常生活能力。结果两组患者手术穿刺成功率比较,差异无统计学意义(P>0.05);观察组患者靶点命中率高于对照组(P<0.05)。观察组患者术后再出血率、病死率分别为0、4.2%,低于对照组患者的16.7%、25.0%(P<0.05)。观察组患者日常生活能力量表(ADL)评分为(59.9±16.8)分,高于对照组的(49.7±15.3)分(P<0.05)。结论改良颅内血肿微创穿刺清除术治疗小脑出血的手术穿刺靶点命中率较高,术后再出血率和病死率较低,有利于提高患者日常生活能力,可行性好,安全性高。
Objective To evaluate the feasibility and safety of modified intracranial hematoma minimally invasive surgery on cerebellar hemorrhage.Methods From February 2012 to February 2014,a total of 48 patients with cerebellar hemorrhage were selected in the National Hospital of Guangxi Zhuang Autonomous Region（National Hospital Affiliated to Guangxi Medical University）,and they were randomly divided into control group and observation group,each of 24 cases.Patients of control group were treated with traditional intracranial hematoma minimally invasive surgery,while patients of observation group were treated with modified intracranial hematoma minimally invasive surgery,including CT positioning,monitoring intracranial pressure and mild hypothermia therapy during surgery,low-body position and low-pressure drainage after surgery.Successful rate of puncture,target conformed rate,recurrent hemorrhage rate after surgery,fatality rate and activity of daily living after 6 months of surgery were compared between the two groups.Results No statistically significant differences of successful rate of puncture was found between the two groups（P〈0.05）;while target conformed rate of observation group was statistically significantly higher than that of control group（P〉0.05）.The recurrent hemorrhage rate after surgery of observation group was 0,was statistically significantly lower than that of control group of 16.7%;the fatality rate of observation group was 4.2%,was statistically significantly lower than that of control group of 25.0%（P〈0.05）.The ADL score of observation group was（59.9 ± 16.8）,was statistically significantly higher than that of control group of（49.7 ± 15.3）（P〈0.05）.Conclusion The target conformed rate of modified intracranial hematoma minimally invasive surgery is higher in treating cerebellar hemorrhage,and the recurrent hemorrhage rate and fatality rate are lower,it is helpful to improve the activity of daily living,has good feasibility and high safety.
出处
《实用心脑肺血管病杂志》
2015年第5期110-112,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
广西壮族自治区崇左市科技局资助项目(1252402):颅内血肿微创穿刺清除术最佳手术时机的临床研究
关键词
脑出血
血肿微创穿刺清除术
治疗结果
Cerebellar hemorrhage
Hematoma minimally invasive surgery
Treatment outcome
