本文選題：CTA點狀征 + 高血壓基底節(jié)區(qū)腦出血��； 參考：《國際神經(jīng)病學(xué)神經(jīng)外科學(xué)雜志》2017年05期

【摘要】：目的根據(jù)CTA"點狀征"是否存在對腦出血分類,研究開顱血腫清除術(shù)和鉆孔引流術(shù)治療中等量(30ml~60 ml)高血壓基底節(jié)區(qū)腦出血的療效,探討手術(shù)方式的選擇。方法選擇中等量高血壓基底節(jié)區(qū)腦出血166例,根據(jù)是否存在CTA"點狀征"分為兩類。每種類型的腦出血再次隨機分為兩組,分別行開顱血腫清除術(shù)和鉆孔引流術(shù)治療。比較CTA"點狀征"陽性及陰性病例經(jīng)過不同手術(shù)方式治療后的再出血率、死亡率、發(fā)病后90d的改良Rankin評分(mRS)及日常生活能力評分(Barthel指數(shù)),對兩種手術(shù)方式進行評價,探討中等量腦出血手術(shù)方式的選擇。結(jié)果對于CTA"點狀征"陽性病例,鉆孔引流術(shù)組的再出血率、死亡率均高于開顱手術(shù)組(P0.05),生活依賴性比例(mRS2)及預(yù)后良好比例(Barthel指數(shù)≥90)的差異無統(tǒng)計學(xué)意義。對于CTA"點狀征"陰性病例,兩組的再出血率、死亡率、生活依賴性比例及預(yù)后良好比例的差異均無統(tǒng)計學(xué)意義。結(jié)論對于CTA"點狀征"陽性病例,適宜行開顱手術(shù)治療,能夠降低再出血率及死亡率。對于CTA"點狀征"陰性病例,適宜行鉆孔引流術(shù)治療,操作簡單,創(chuàng)傷較小。兩種手術(shù)方式對于存活患者的預(yù)后影響沒有差異。術(shù)前對病人進行合理的分類是必要的,CTA"點狀征"為我們提供了一種良好的分類依據(jù)。
[Abstract]:Objective according to the classification of intracerebral hemorrhage (ICH) by CTA "dot sign", to study the curative effect of craniotomy and borehole drainage in treating hypertensive basal ganglia intracerebral hemorrhage with moderate dose of 30 ml ~ 60 ml), and to explore the choice of surgical methods. Methods 166 patients with moderate hypertensive basal ganglia hemorrhage were divided into two groups according to the existence of CTA "dot sign". Each type of intracerebral hemorrhage was randomly divided into two groups. The rate of rebleeding, mortality, modified Rankin score (mRSs) and activity of daily living (ADL) were compared between positive and negative patients with CTA "dot sign" after different surgical treatment. The two operative methods were evaluated. To explore the choice of surgical methods for moderate intracerebral hemorrhage. Results there was no significant difference in the rate of rebleeding, mortality rate and life dependence ratio (mRS2) and the ratio of Barthel index (鈮，

本文編號：2026757