方體定向軟通道技術(shù)治療重癥高血壓腦出血患者的療效分析
發(fā)布時(shí)間:2018-04-04 03:44
本文選題:方體定向軟通道 切入點(diǎn):開(kāi)顱手術(shù) 出處:《延邊大學(xué)》2017年碩士論文
【摘要】:目的分析方體定向軟通道技術(shù)和開(kāi)顱手術(shù)治療重癥高血壓腦出血患者的治療效果。方法收集本院2014年9月至2016年10月神經(jīng)外科住院手術(shù)治療的重癥高血壓腦出血患者120例,隨機(jī)分為方體定向軟通道組(簡(jiǎn)稱微創(chuàng)組,60例)和開(kāi)顱手術(shù)組(開(kāi)顱組,60例),比較分析了兩組患者的臨床資料,術(shù)前血腫量和GCS評(píng)分、發(fā)病至開(kāi)始手術(shù)時(shí)間、手術(shù)時(shí)間、術(shù)后(1d、3d、7d)殘余血量和GCS評(píng)分,平均住院日、住院費(fèi)用、感染率、死亡率、再出血率、術(shù)后6個(gè)月GOS評(píng)分、mRS評(píng)分和神經(jīng)功能恢復(fù)良好率。結(jié)果與開(kāi)顱組比較,微創(chuàng)組手術(shù)時(shí)間(1.52±0.27h vs 0.23±0.05h)明顯縮短,兩組比較有統(tǒng)計(jì)學(xué)差異(P0.001);第3d和7d微創(chuàng)組殘余血腫量少于開(kāi)顱組,有統(tǒng)計(jì)學(xué)差異(P0.001);第3d、7dGCS評(píng)分微創(chuàng)組優(yōu)于開(kāi)顱組(P0.001)。與開(kāi)顱組比較,微創(chuàng)組平均住院日(14.45±4.44d vs 9.15±1.75d明顯縮短(P0.001),微創(chuàng)組住院費(fèi)用明顯少于開(kāi)顱組(16,915.9元vs 32,249.3元,P0.001);與開(kāi)顱組比較,微創(chuàng)組感染率和死亡率均明顯下降(P0.05),兩組再出血率無(wú)統(tǒng)計(jì)學(xué)差異,術(shù)后6個(gè)月GOS評(píng)分和mRS評(píng)分均無(wú)統(tǒng)計(jì)學(xué)差異,微創(chuàng)組神經(jīng)功能恢復(fù)良好率(38.3%vs 18.3%)明顯高于開(kāi)顱組(P0.05)。結(jié)論方體定向軟通道技術(shù)治療重癥高血壓腦出血,是一種創(chuàng)傷小、定位準(zhǔn)確、操作簡(jiǎn)便、費(fèi)用低廉的手術(shù)方法,提高患者的生存率,減少并發(fā)癥及后遺癥。
[Abstract]:Objective to analyze the effect of soft channel technique and craniotomy in the treatment of severe hypertensive intracerebral hemorrhage.Methods 120 patients with severe hypertensive intracerebral hemorrhage treated by neurosurgery from September 2014 to October 2016 were collected.The patients were randomly divided into two groups: the soft channel group (60 cases) and the craniotomy group (60 cases). The clinical data, preoperative hematoma volume and GCS score, the time from onset to the beginning of operation, and the time of operation were compared and analyzed between the two groups.Residual blood volume and GCS score, average hospitalization days, hospitalization expenses, infection rate, mortality rate, rebleeding rate, GOS score and neurological function recovery rate 6 months after operation.緇撴灉涓庡紑棰呯粍姣旇緝,寰垱緇勬墜鏈椂闂,
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