微创颅内血肿清除术对老年高血压脑出血患者近期疗效的影响.pdfVIP

微创颅内血肿清除术对老年高血压脑出血 患者近期疗效的影响 王玖飞 李 明 赵 刚 目的 探讨微创颅内血肿清除术与保守治疗对高血压脑出血老年患者近期疗效的影响。 方法将60例高血压脑出血老年患者随机等分微创组和保守组，微创组采用YL-1型穿刺针刺入血肿边缘， 缓慢穿刺至血肿边缘进行抽吸，保守组采用降压药、脱水剂、清除自由基和营养脑神经细胞等保守治疗。观察 两组血肿清除时间、神经功能恢复和术后生活能力等方面临床疗效。结果微创组和保守组血肿清除时间分 别为(4.5±1.2)d和(17.0±1.9)d，两组比较差异有统计学意义(t=16.04，P＜0.05)；微创组和保守组神经 功能恢复有效率分别为66.7％和93.3％，两组比较差异有统计学意义(x2=5.46，P＜0.05)；微创组和保守组 日常生活能力恢复总有效率分别为80.0％和50.0％，两组比较差异有统计学意义(x2=5.93，P＜0.05)；微创 组和保守组并发症发生率分别为30.0％和66.7％，两组比较差异有统计学意义(x2=8.08，P＜0.05)。 结论 微创颅内血肿清除术是治疗老年高血压脑出血的理想方法，可明显缩短血肿清除时间，提高患者生存 质量，从而改善预后。 微创；清除术；颅内血肿；高血压 Effectofminimallyinvasiveremovalofintracranialhematomaincuringhypertensioncerebralhemorrhageof elderlypatients WANGJiu-fei* LIMing,ZHAOGang.*DepartmentofNeurosurgery,NormanBethuneFirstHospi talofJilinUniversity,Changchun,Jilin130021,China Objective Tocomparethetherapeuticeffectofmininal]yinvasiveremovalofintracranialhema tomaandconservativetreatmentincuringhypertensioncerebralhemorrhageofelderlypatients.Methods 60patients withhypertensioncerebralhemorrhageweredividedintotwogroups.GroupAwereadoptedminimallyinvasiveremov alofintracranialhematoma(YL-1typepunctureneedlewasusedintothehematomaedge,andsuckedslowlythehe matoma),andgroupBwereadoptedmedicaltreatment(antihypertensivedrugs,dehydration,freeradicalsandnutrition conservativetreatment),thenclinicaltherapeuticeffectandactivityofdailylivingwereobserved.Results Thehe matomaevacuationtimeingroupA(4.5± 1.2)disshorterthaningroupB(17.0± 1.9)d(t=6.04,P＜ 0.05);The rateofneurologicalfunctionrecoveryingroupA(66.7％ )ishigherthaningroupB(93.3％ )(x2=5.46,P＜ 0.05);TheactivityofdailylivingingroupA(80.0％ )wasbetterthangroupB(50.0％ )(x2=5.93,P＜ 0.05). ThecomplicationrateingroupA(30.0％)islowerthaningroupB(66.7％)(x2=8.08,P＜ 0.05). Conclusion Thetherapeuticeffectofminimallyinvasiveremovalofintracranialhematomaincuringhypertension cerebralhemorrhagewasbetterthanmedicaltreatment. Minimallyinvasive;Remova