摘要
目的比较超早期与早期小骨窗微创血肿清除术治疗高血压基底核区出血的临床疗效。方法选取2013年4月—2014年4月南阳市中心医院收治的高血压基底核区出血患者80例,依据发病至手术时间分为超早期组（发病至手术时间〈6 h）和早期组（发病至手术时间为6-48 h）,各40例。两组患者均行小骨窗微创血肿清除术治疗,并随访6个月。比较两组患者血肿清除率、并发症（包括肺部感染、泌尿系统感染及消化道出血等）发生率,术前及术后3个月美国国立卫生研究院卒中量表（NIHSS）评分、中国卒中量表（CSS）评分及Barthel指数评分,术后6个月再出血发生率及病死率。结果两组患者血肿清除率比较,差异无统计学意义（P〉0.05）;早期组患者肺部感染发生率、泌尿系统感染发生率、消化道出血发生率均高于超早期组（P〈0.05）。两组患者术前NIHSS评分、CSS评分及Barthel指数评分比较,差异无统计学意义（P〉0.05）;早期组患者术后3个月NIHSS评分、CSS评分均高于超早期组,Barthel指数评分低于超早期组（P〈0.05）。早期组患者术后6个月再出血发生率低于超早期组（P〈0.05）;两组患者病死率比较,差异无统计学意义（P〉0.05）。结论超早期与早期小骨窗微创血肿清除术治疗高血压基底核区出血各具优势,因此,临床应根据患者具体情况选择更适合的手术时机。
Objective To compare the comparative study for clinical effect on hypertensive basal ganglia hemorrhage between ultra- early and early minimally invasive small bone- window evacuation of hematoma. Methods A total of 80 patients with hypertensive basal ganglia hemorrhage were selected in the Central Hospital of Nanyang from April 2013 to April 2014,and they were divided into A group（ with duration between onset and operation less than 6 hours） and B group（ with duration between onset and operation equal or over 6 hours,but equal or less than 48 hours） according to the duration between onset and operation,each of 40 cases. Patients of both groups received minimally invasive small bone- window evacuation of hematoma,and they were followed up for 6 months. Hematoma clearance rate,incidence of complications（ including pulmonary infection,urinary system infection and gastrointestinal hemorrhage）,NIHSS score,CSS score and Barthel score before operation and after 3months of operation,incidence of rehaemorrhagia and fatality rate after 6 months of operation were compared between the two groups. Results No statistically significant differences of hematoma clearance rate was found between the two groups（ P〈0. 05）; the incidence of pulmonary infection,urinary system infection and gastrointestinal hemorrhage of A group was statistically significantly higher than that of B group,respectively（ P〈0. 05）. No statistically significant differences of NIHSS score,CSS score or Barthel index score was found between the two groups before operation（ P〈0. 05）; NIHSS score and CSS score of A group were statistically significantly lower than those of B group after 3 months of operation,while Barthel index score of A group was statistically significantly higher than that of B group after 3 months of operation（ P〈0. 05）. The incidence of rehaemorrhagia of A group was statistically significantly lower than that of B group after 6 months of operation（ P〈0. 05）,while no statistically significant differences of fatality rate was found between the two groups after 6 months of operation（ P〈0. 05）.Conclusion Both of ultra- early and early minimally invasive small bone- window evacuation of hematoma have certain advantages in treating hypertensive basal ganglia hemorrhage,clinicians should make reasonable choice according to the patients＇ specific conditions.
出处
《实用心脑肺血管病杂志》
2016年第4期64-66,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
脑血管基底神经节出血
高血压
小骨窗微创血肿清除术
疗效比较研究
Basal ganglia hemorrhage
Hypertension
Minimally invasive small bone-window evacuation of hematoma
Comparative effectiveness research
