[1]阿布都克尤木·阿布都吉力力,帕热哈提江·依孜木,李津生,等.两种不同手术方式治疗基底节区高血压脑出血的临床疗效[J].临床神经外科杂志,2018,15(05):354-361.[doi:10.3969/j.issn.1672-7770.2018.05.009]
 Abdukeyum Abdujilil,Parhatjan Yizim,LI Jin-sheng,et al.Comparative study on early prognosis of hypertensive cerebral hemorrhage in basal ganglia by different surgical methods[J].Journal of Clinical Neurosurgery,2018,15(05):354-361.[doi:10.3969/j.issn.1672-7770.2018.05.009]
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两种不同手术方式治疗基底节区高血压脑出血的临床疗效()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
15
期数:
2018年05期
页码:
354-361
栏目:
论著
出版日期:
2018-10-15

文章信息/Info

Title:
Comparative study on early prognosis of hypertensive cerebral hemorrhage in basal ganglia by different surgical methods
作者:
阿布都克尤木·阿布都吉力力帕热哈提江·依孜木李津生麦麦提依明·托合提董军吴永刚杨小朋
830001乌鲁木齐,新疆维吾尔自治区人民医院神经外科
Author(s):
Abdukeyum AbdujililParhatjan YizimLI Jin-shenget al.
Department of Neurosurgery,The People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China
关键词:
基底节区脑出血高血压手术预后
Keywords:
basal gangliacerebral hemorrhagehypertensionsurgical approachprognosis
分类号:
R651.1
DOI:
10.3969/j.issn.1672-7770.2018.05.009
文献标志码:
A
摘要:
目的 探讨微创穿刺血肿清除术及开颅血肿清除术治疗基底节区高血压脑出血(hypertensive cerebral hemorrhage,HCH)的临床疗效。方法 将新疆维吾尔自治区人民医院神经外科2014年11月至2017年12月收治的246例基底节区高血压脑出血患者,按手术方式分为微创穿刺血肿清除组(微创组,154例)和开颅血肿清除组(开颅组,92例)。开颅组患者行常规去大骨瓣清除血肿术,观察组患者行微创穿刺血肿清除引流术治疗。比较两组患者的术中出血量、手术时间、术后意识恢复时间及血肿清除率和术后并发症。患者术后随访6个月,统计各组的死亡率,并用日常生活能力(activity of daily living,ADL)评分评定预后。结果 微创组术中出血量、手术时间、术后意识恢复时间均明显低于开颅组(P=0.000,P=0.000,P=0.001)。两组血肿清除率比较,差异无统计学意义(P>0.05)。微创组术后并发症发生率(9.09%)明显低于开颅组(23.91%)(χ2=5.064,P=0.024)。术后6个月时,两组死亡率比较,差异无统计学意义(P>0.05);微创组的ADL评分优良率(82.19%)明显高于开颅组(58.14%)(P=0.000)。结论 微创穿刺血肿清除术治疗高血压脑出血的临床疗效较好。其可有效清除血肿,缩短手术时间及术后恢复时间,并发症少;术后患者的生活能力恢复良好;值得临床推广应用。
Abstract:
Abstract:Objective To investigate the clinical curative effect and early prognosis of patients with hypertensive cerebral hemorrhage(HCH) in basal ganglia by the different surgical methods.Methods 246 patients admitted to The People’s Hospital of Xinjiang Uygur Autonomous Region from November 2014 to December 2017 were divided into observation group (154 cases) and control group (92 cases).The control group was treated with routine removal of hematoma by craniotomy.The observation group was treated with minimally invasive hematoma puncture drainage.The intraoperative blood loss,the operation time,the postoperative recovery time and the hematoma clearance rate of the two groups were observed and compared.The postoperative complications were recorded.All patients were followed up for 6 months and the mortality rate and ADL score were recorded.Results The intraoperative blood loss,the operation time and the postoperative recovery time in observation group were lower than those of the control group (t=-29.508,P=0.000,t=-12.339,P=0.000,t=-3.507,P=0.001).There was no significant difference of the hematoma clearance rate between the two groups (P>0.05).The incidence of postoperative complications of in the observation group was lower than that in the control group (9.09% vs 23.91%,χ2=5.064,P=0.024).After 6 months of follow-up,there was no significant difference of mortality rate between the two groups (P>0.05).The rate of ADL score in the observation group was higher than that in the control group (82.22% vs 58.14%,Z=-5.043,P=0.000).Conclusions The minimally invasive hematoma puncture drainage has the exact clinical curative effect in the treatment of the hypertensive basal ganglia hemorrhage.It can effectively remove the hematoma,shorten the operation time and postoperative recovery time.It also has less complications and high ADL score after operation and worthy for clinical application.

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更新日期/Last Update: 2018-10-10