微创治疗高血压脑出血的临床分析.docVIP

微创治疗高血压脑出血的临床分析 　　摘要：目的 探讨比较钻孔引流术和小骨窗开颅治疗高血压脑出血的临床疗效。方法 选取我院从2006年6月~2013年6月接受微创治疗的高血压脑出血患者152例，分为钻孔引流组（88例）以及小骨窗开颅组（64例），比较两组的手术时间，血肿清除率，手术后拔除引流管的时间，急性期神经功能改善情况，手术后并发症以及手术后3个月的日常生活能力（ADL）以及病死率。结果 钻孔引流组的手术时间短于小骨窗开颅组（P0．05)。在急性期神经功能改善情况以及两组患者手术后3个月ADL各个级别和死亡率的比较差异无统计学意义(P0．05)。结论 钻孔引流术和小骨窗血肿清除术都是治疗高血压脑出血行之有效的微创治疗，各有利弊，可以综合多方面因素进行选择。 　　关键词：高血压脑出血；微创治疗；临床疗效 　　Clinical Analysis on Minimally Invasive Treatment in Patients with Hypertensive Cerebral Hemorrhage 　　ZHAO Zhan,YIN Li-ming,ZHUO Li-xia,ZHONG De-quan,WANG Wen-tao,XU Wei-guang, ZHANG Wei 　　(Department of Neurosurgery,The First Affiliated Hospital,Guangdong Pharmaceutical University,Guangzhou 510080,Guangdong,China) 　　Abstract：ObjectiveTo discuss clinical effects between trepanation drainage and small bone window craniotomy group in treating hypertensive hemorrhage patients.MethodsWe reviewed 152 cases after Mini-wound treatment in hypertensive hemorrhage from June 2006 to June 2011.The cases were divided into minimally invasive trepanation and drainage and craniotomy group with small bone window craniotomy group.The operation time,hematoma clearance rate,drainage tube extraction time,acute neurological function improvement,postoperative complications and activity of daily living of 3 months after surgery were compared.Results Trepanation drainage group have lower rates of operation time and Hematoma clearance rate but higher rates of drainage tube extraction time and Intracranial rehaemorrhagia than those of small bone window craniotomy group（P0.05）. No significantly differences were found in complications of Pneumonia,electrolyte disturbances,gastrointestinal bleeding,intracranial infection,acute kidney injury,urinary tract infection,acute neurological improvement,3 monthsADL after surgery and mortality rate.Conclusion Both trepanation drainage and small bone window craniotomy groups are effective minimally invasive treatment in treating hypertensive hemorrhage patients. Many factors can be integrated to