成人幕上深部脑血肿手术治疗与保守治疗的临床疗效对比研究-外科学(神经外科)专业论文.docx

英汉缩略语名词对照 英文缩写 英文全称 中文全称 HICH STICH GCS GOS mRS  Hypertensive Cerebral Hemorrhage Surgical Trial in Intracerebral Haemorrhage Glasgow Coma Scale Glasgow Outcome Scale Modified Ranking Scale 高血压脑出血 脑出血的外科治疗试验 格拉斯哥昏迷指数 格拉斯哥预后指数 改良脑卒中等级量表 1 成人幕上深部脑血肿手术治疗与保守治疗的临床疗效 对比研究 摘要 目的：对成人幕上深部脑血肿（血肿量≥30mL，距皮层距离大于 1cm）手术治疗与保守治疗的疗效分析。 方法：回顾性分析重庆医科大学附属第一医院神经外科 2013-01 至 2014-06 收治并诊断为高血压脑出血的病人共 112 例，分为手术治疗 组（55 例）及保守治疗组（57 例），分析和比较两组的死亡率、预后 转归及并发症发生率。 结果：评价死亡率方面，手术组与保守治疗组 3 周内的死亡率分 别为 5.45%和 17.54%，比较差异有统计学意义（P0.05）；而 3 月内各 组的死亡率分别为 16.36%和 22.81%，比较差异无统计学意义（P0.05）； 在临床预后方面，3 月时 GOS 预后评分、改良 Ranking 量表评分及不 良转归情况，手术组均优于保守治疗组（P0.05）；在并发症方面，手 术组与保守组并发症发生率分别为 20.0%和 36.84%（P0.05），各组出 现并发症患者中，随访 3 月内的死亡率分别是无并发症者的 5.00 倍和 3.86 倍。 结论：对于血肿量≥30mL，距皮层距离大于 1cm 以上成人幕上深 部脑血肿治疗后的早期死亡率、预后转归、并发症的发生率方面，手 2 术治疗均优于保守治疗。 关键词：成人幕上深部脑血肿；高血压脑出血；骨瓣开颅术；保 守治疗 3 A COMPARATIVE STUDY OF SURGICAL AND CONSERVATIVE THERAPEUTIC EFFECTS IN ADULT DEEP SUPRATENTORIAL INTRACEREBRAL HEMATOMAS ABSTRACT Objective: To compare the efficacy between the standardized surgical treatment and the conservative treatment in adult deep supratentorial intracerebral hematomas (The volume of the hematoma is more than 30mL while the distance from the cerebral cortex is more than 1cm). Methods: A retrospective trial was undertook from January 2013 to June 2014. All the cases with hypertensive intracerebral hemorrhage were devided into surgical (55 cases) and conservative group (57 cases). The statistic analysis was processed to compare the mortality, long-time outcome, and the incidence of associated complications of each group. Results: The mortality rates within 3 weeks and 3 months of the surgical group were 5.5% and 16.36% while of the conservative group were 17.6% and 36.8%. The early mortality of the surgical group was lower than that of the conservative group with significant differences (P0.05). To compare the clinical curative effects which were followed up 3 months, the GOS, mRS and the adverse outcomes of the surgical grou