[1]耿锋,张志文,杨非,等.大骨瓣开颅术治疗重症高血压脑出血的疗效分析[J].临床神经外科杂志,2019,16(3):273-276.[doi:10.3969/j.issn.1672-7770.2019.03.020]
 GENG Feng,ZHANG Zhi-wen,YANG Fei,et al.Effectiveness analysis on large bone craniectomy for severe hypertensive hemorrhage[J].Journal of Clinical Neurosurgery,2019,16(3):273-276.[doi:10.3969/j.issn.1672-7770.2019.03.020]
点击复制

大骨瓣开颅术治疗重症高血压脑出血的疗效分析()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第3期
页码:
273-276
栏目:
临床研究
出版日期:
2019-06-15

文章信息/Info

Title:
Effectiveness analysis on large bone craniectomy for severe hypertensive hemorrhage
作者:
耿锋张志文杨非查伟光赵飞查智健李光照陆昌燕
230000 合肥,安徽省合肥市滨湖医院神经外科(耿锋,杨非,赵飞,查智健,李光照,陆昌燕);中国人民解放军总医院第四医学中心神经外科(张志文,查伟光)
Author(s):
GENG Feng ZHANG Zhi-wen YANG Fei et al.
Department of Neurosurgery, Hefei First People’s Hospital Group South District Binhu Hospital, Hefei 230000, China
关键词:
重症高血压脑出血手术治疗大骨瓣减压术小骨窗减压术
Keywords:
severe hypertensive cerebral hemorrhage surgical treatment large bone flap decompression small bone window decompression
分类号:
R544.1;R743.34
DOI:
10.3969/j.issn.1672-7770.2019.03.020
文献标志码:
D
摘要:
【摘要】目的 探讨大骨瓣开颅术在重症高血压脑出血治疗中与单纯开颅血肿清除术的疗效比较。方法选取安徽省合肥市滨湖医院2014年1月—2018年11月手术治疗的66例高血压脑出血患者。根据患者的病情分为开颅血肿清除+大骨瓣减压组(去骨瓣组,骨窗减压范围至少为10 cm×12 cm)和单纯开颅血肿清除组(单纯开颅组,小骨窗开颅血肿清除)。术后1个月时进行格拉斯哥预后量表(Glasgow outcome scale, GOS)评分,比较两种手术患者的近期疗效。结果去骨瓣组恢复良好(GOS评分4~5分)、恢复较差(GOS评分2~3分)、死亡的患者分别为12例(36.4%)、16例(48.5%)、5例(15.1%);单纯开颅组分别为16例(48.5%)、7例(21.2%)、10例(30.3%)。两组间预后的差异有统计学意义(χ2值17.28,P=0.000 2)。结论单纯血肿清除术对重症高血压脑出血的减压效果不显著。而大骨瓣减压术与其相比,则能取得较好的效果,可明显降低重症高血压脑出血的死亡率。
Abstract:
Abstract: ObjectiveTo explore curative effect of large bone flap craniectomy in the treatment of severe hypertensive cerebral hemorrhage(HCH) compared with other surgical methods. Methods66 patients with HCH underwent surgery from January 2014 to November 2018 were selected in Binhu Hospital of Hefei City, Anhui Province. According to the patients situation and condition, they were divided into hematoma removal+big bone flap craniectomy decompression groups(de-bone flap group, bone window decompression range is at least 10 cm×12 cm) and pure craniotomy hematoma removal group(simple craniotomy group, small bone window craniotomy hematoma clearance). Glasgow outcome scale(GOS) scores were performed after 1 month postoperatively to compare the short-term outcomes of the two surgical patients. ResultsThe group of decompression well recovered (GOS score 4-5) , poor recovered(GOS score 2-3), and the patients died were 12(36.4%), 16(48.5%), and 5(15.1%). The simple craniotomy group were 16 cases(48.5%), 7 cases(21.2%), and 10 cases(30.3%). The difference in prognosis between the two groups was statistically significant(χ2 value 17.28,P=0.0002). ConclusionsThe effect of simple hematoma evacuation on decompression of severe hypertensive cerebral hemorrhage is not sufficient. Compared with large bone flap decompression, it can achieve better results and significantly reduce the mortality of severe hypertensive cerebral hemorrhage.

相似文献/References:

[1]徐祎,杜世伟,高天.腕管镜下Chow法手术治疗糖尿病腕管综合征[J].临床神经外科杂志,2015,(01):58.
[2]李云翔,费舟.脑挫裂伤手术与非手术治疗对照研究[J].临床神经外科杂志,2014,(02):140.
[3]张杰,高晋健,吴建兵,等.伽玛刀与手术治疗颞叶癫痫的疗效分析[J].临床神经外科杂志,2014,(04):265.
[4]徐勇,林爱明,刘佳骐.预见性双侧去骨瓣减压与相继性双侧去骨瓣减压治疗重型颅脑损伤临床疗效的差异性分析[J].临床神经外科杂志,2014,(06):470.
 Xu Yong,Lin Aiming,Liu Jia Qi.Clinical features and Surgical treatment of traumatic intracerebral hemorrhage[J].Journal of Clinical Neurosurgery,2014,(3):470.
[5]王金龙,刘亚军,罗坤,等.脊柱旁与椎管内节细胞神经瘤的临床诊断及外科手术治疗[J].临床神经外科杂志,2017,14(05):356.
 WANG Jin-long,LIU Ya-jun,LUO Kun,et al.Clinical diagnosis and surgical treatment of paravertebral and spinal ganglioneuroma[J].Journal of Clinical Neurosurgery,2017,14(3):356.
[6]贡伟一,周金方,王文明.小脑出血的手术治疗(附35例临床分析)[J].临床神经外科杂志,2018,15(01):62.[doi:10.3969/j.issn.1672-7770.2018.01.015]
 GONG Wei-yi,ZHOU Jin-fang,WANG Wen-ming..Surgical treatment of cerebellar hemorrhage (a clinical analysis of 35 cases)[J].Journal of Clinical Neurosurgery,2018,15(3):62.[doi:10.3969/j.issn.1672-7770.2018.01.015]
[7]闫天芳,刘钊,刘攀,等.3D1H-MRS多模态成像技术辅助下扩大胶质瘤手术切除范围的研究[J].临床神经外科杂志,2018,15(06):452.[doi:10.3969/j.issn.1672-7770.2018.06.013]
 YAN Tian-fang,LIU Zhao,LIU Pan,et al.Reaserch on enlarged surgical resection range of glioma with assistant of 3D1H-MRS multimodal imaging[J].Journal of Clinical Neurosurgery,2018,15(3):452.[doi:10.3969/j.issn.1672-7770.2018.06.013]
[8]姚林,冯鸣,王杭州,等.硬脊膜外脓肿4例临床分析[J].临床神经外科杂志,2019,16(1):41.[doi:10.3969/j.issn.1672-7770.2019.01.009]
 YAO Lin,FENG Ming,WANG Hang-zhou,et al.Clinical analysis of spinal epidural abscess[J].Journal of Clinical Neurosurgery,2019,16(3):41.[doi:10.3969/j.issn.1672-7770.2019.01.009]
[9]宋晨,张楠楠,胡喻,等.垂体腺瘤手术治疗中对垂体功能保护的研究[J].临床神经外科杂志,2019,16(2):115.[doi:10.3969/j.issn.1672-7770.2019.02.005]
 SONG Chen,ZHANG Nan-nan,HU Yu,et al.Functional protection during operations of pituitary adenoma[J].Journal of Clinical Neurosurgery,2019,16(3):115.[doi:10.3969/j.issn.1672-7770.2019.02.005]
[10]郑重,王秀,桑林,等.胚胎发育不良性神经上皮肿瘤继发癫痫的手术疗效及预后影响因素分析[J].临床神经外科杂志,2019,16(4):314.[doi:10.3969/j.issn.1672-7770.2019.04.008]
 ZHENG Zhong,WANG Xiu,SANG Lin,et al.Surgical treatment of epilepsy due to dysembryoplastic neuroepithelial tumor and prognosis of seizure outcome[J].Journal of Clinical Neurosurgery,2019,16(3):314.[doi:10.3969/j.issn.1672-7770.2019.04.008]

更新日期/Last Update: 2019-06-15