开颅血肿清除术联合去骨瓣减压术治疗高血压脑出血的近期疗效及患者预后分析
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摘要
目的探讨开颅血肿清除术联合去骨瓣减压术治疗高血压脑出血的效果。方法回顾性分析我院2014年1月至2018年3月收治的130例高血压脑出血患者的临床资料,根据手术方式将其分为观察组(开颅血肿清除术联合去骨瓣减压术, n=68)与对照组(微创锥颅血肿穿刺引流, n=62例),比较两组的手术效果。结果观察组的术中脑组织获得减压时间、手术时间以及住院时间明显长于对照组(P <0.05)。观察组血肿清除率明显高于对照组(P <0.05)。两组的NIHSS评分、 Barthel评分以及术后不良反应发生率比较均无统计学差异(P>0.05)。结论开颅血肿清除术联合去骨瓣减压术以及微创锥颅血肿穿刺引流均可有效治疗高血压脑出血。
Objective To explore the effect of craniotomy evacuation of hematoma combined with decompressive craniectomy in the treatment of hypertensive cerebral hemorrhage. Methods The clinical data of 130 patients with hypertensive cerebral hemorrhage admitted to our hospital from January 2014 to March 2018 were retrospectively analyzed. According to operation methods, they were divided into observation group(craniotomy evacuation of hematoma combined with decompressive craniectomy, n = 68) and control group(minimally invasive hematoma puncture drainage, n = 62). The operation effects were compared between the two groups. Results The intraoperative decompression time of brain tissues, operation time and hospitalization time of the observation group were significantly longer than those of the control group(P <0.05). The hematoma clearance rate of the observation group was significantly higher than that of the control group(P<0.05). No statistical difference was found in the NIHSS score, Barthel score and incidence of postoperative adverse reactions between the two groups(P >0.05). Conclusions Craniotomy evacuation of hematoma combined with decompressive craniectomy and minimally invasive hematoma puncture drainage both can effectively treat hypertensive cerebral hemorrhage.
Objective To explore the effect of craniotomy evacuation of hematoma combined with decompressive craniectomy in the treatment of hypertensive cerebral hemorrhage. Methods The clinical data of 130 patients with hypertensive cerebral hemorrhage admitted to our hospital from January 2014 to March 2018 were retrospectively analyzed. According to operation methods, they were divided into observation group(craniotomy evacuation of hematoma combined with decompressive craniectomy, n = 68) and control group(minimally invasive hematoma puncture drainage, n = 62). The operation effects were compared between the two groups. Results The intraoperative decompression time of brain tissues, operation time and hospitalization time of the observation group were significantly longer than those of the control group(P <0.05). The hematoma clearance rate of the observation group was significantly higher than that of the control group(P<0.05). No statistical difference was found in the NIHSS score, Barthel score and incidence of postoperative adverse reactions between the two groups(P >0.05). Conclusions Craniotomy evacuation of hematoma combined with decompressive craniectomy and minimally invasive hematoma puncture drainage both can effectively treat hypertensive cerebral hemorrhage.
引文
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[2]赵东,蔡强,李明昌,等.小骨瓣神经内镜下手术治疗高血压脑出血临床观察[J].山东医药, 2017, 57(43):55-57.
[3]孙昭胜,赵旺淼,葛春燕,等.开颅血肿清除术和钻孔引流术治疗中等量基底核区高血压脑出血的临床疗效比较研究[J].中国全科医学, 2018, 21(6):702-706.
[4]王金林,黄燕,王大永,等.去骨瓣减压术对高血压脑出血患者脑血流灌注的影响[J].中国老年学杂志, 2017, 37(16):4025-4026.
[5]陈刚,程继勇.开颅血肿清除术和钻孔引流术治疗高血压脑出血疗效比较[J].中国神经精神疾病杂志, 2016, 42(7):431-434.
[6]郑军,甄志勇,党涛.高血压脑出血患者的微创手术及开颅血肿清除术治疗效果比较[J].中华肿瘤防治杂志, 2016, 23(1):255-256.
[7]党帅.比较三种不同手术方式对基底节脑出血患者长期神经功能及颅内感染的影响[J].国际神经病学神经外科学杂志, 2016, 43(6):526-530.