锥颅引流术与小骨窗开颅术治疗高血压基底节区脑出血的临床疗效及对近期预后的影响
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摘要
目的探讨锥颅引流术与小骨窗开颅术治疗高血压基底节区脑出血的临床疗效及对病人近期预后的影响。方法选择2014年5月—2016年10月高血压基底节区脑出血病人164例,根据病人手术方式不同分为锥颅引流术组(引流组)88例和小骨窗开颅术组(开颅组)76例,比较两组术中、术后恢复情况、血肿清除效果、死亡率、对神经功能改善情况、并发症及6个月的预后情况。结果引流组手术时间明显短于开颅组(P<0.05);开颅组术中失血量明显少于引流组、拔管时间和住院时间均短于引流组,差异均有统计学意义(P<0.05)。引流组术后1 d血肿清除率明显低于开颅组(P<0.05);开颅组肺部感染和总发生率均低于引流组,差异有统计学意义(P<0.05)。结论锥颅引流术与小骨窗开颅术对高血压基底节区脑出血病人的神经功能改善和预后的影响相近,小骨窗开颅术创伤较小,恢复较快,并发症较少。
引文
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[11] 吴晓宇.锥颅引流术与小骨窗开颅显微手术治疗高血压基底节区脑出血患者的疗效比较[J].医疗装备,2017,30(6):18-19.
[12] CHOO Y S,CHUNG J,JOO J Y,et al.Borderline basal ganglia hemorrhage volume:patient selection for good clinical outcome after stereotactic catheter drainage[J].Journal of Neurosurgery,2016,125(5):1-3.
[13] 王东兵,高广伟.微创锥颅血肿引流术与小骨窗开颅术治疗高血压脑出血的效果比较[J].保健医学研究与实践,2016,13(6):42-44.
[14] 简晓光.锥颅引流术与小骨窗开颅术治疗高血压脑出血的临床效果比较[J].当代医学,2016,22(30):91-92.
[15] 马现启.小骨窗开颅治疗基底节区高血压脑出血的体会[J].河南外科学杂志,2015,7(2):21-22.
[2] WANG G Q,LI S Q,HUANG Y H,et al.Can minimally invasive puncture and drainage for hypertensive spontaneous basal ganglia intracerebral hemorrhage improve patient outcome:a prospective non-randomized comparative study[J].Medical Journal of Chinese People Liberation Army,2014,1(1):10-11.
[3] 裴明和,孙捷.锥颅引流术与小骨窗开颅术治疗高血压脑出血的疗效对比[J].中国现代医生,2015,53(16):30-32.
[4] 吴承远,刘玉光.临床神经外科学[M].2版.北京:人民卫生出版社,2007:164-165.
[5] LU T S,AN C L,GUAN J Y.Clinical experience:individual surgical therapy of hypertensive basal ganglia hemorrhage[J].Journal of Neurosurgical Sciences,2015,17(9):204-205.
[6] HARSHA K J,PARAMESWARAN K.Adult post-varicella small vessel vaculopathy mimicking hypertensive basal ganglia hemorrhage with coexisting infarcts[J].Neurology India,2016,64(6):1323-1325.
[7] 王立江,张吉荣,韩光良,等.CT定位下微创穿刺治疗高血压基底节区脑出血短期疗效分析[J].中华老年心脑血管病杂志,2014,16(4):391-394.
[8] ZHAO J,CHEN Z,WANG Z,et al.Simultaneous bilateral hypertensive basal ganglia hemorrhage[J].NeurologiaI Neurochirurgia Polska,2016,50(4):275-276.
[9] 李建明,张诚.锥颅引流术与小骨窗开颅显微手术治疗高血压基底节区脑出血的疗效比较[J].中国实用神经疾病杂志,2016,19(21):5-8.
[10] VEGA M B,HAMAMOTO FILHO P T,MACHADO C J,et al.Traumatic brain injury presenting with bilateral basal ganglia hemorrhage[J].Neurologia I Neurochirurgia Polska,2015,49(6):456-459.
[11] 吴晓宇.锥颅引流术与小骨窗开颅显微手术治疗高血压基底节区脑出血患者的疗效比较[J].医疗装备,2017,30(6):18-19.
[12] CHOO Y S,CHUNG J,JOO J Y,et al.Borderline basal ganglia hemorrhage volume:patient selection for good clinical outcome after stereotactic catheter drainage[J].Journal of Neurosurgery,2016,125(5):1-3.
[13] 王东兵,高广伟.微创锥颅血肿引流术与小骨窗开颅术治疗高血压脑出血的效果比较[J].保健医学研究与实践,2016,13(6):42-44.
[14] 简晓光.锥颅引流术与小骨窗开颅术治疗高血压脑出血的临床效果比较[J].当代医学,2016,22(30):91-92.
[15] 马现启.小骨窗开颅治疗基底节区高血压脑出血的体会[J].河南外科学杂志,2015,7(2):21-22.