發(fā)布時(shí)間：2019-03-21 12:38

【摘要】：目的:探討微創(chuàng)穿刺引流術(shù)治療高血壓腦出血的臨床療效。本研究擬通過(guò)比較微創(chuàng)穿刺引流術(shù)與開(kāi)顱手術(shù)治療高血壓腦出血的臨床療效,探討微創(chuàng)穿刺引流術(shù)治療高血壓腦出血的臨床優(yōu)勢(shì),以便更好的指導(dǎo)臨床治療。方法:選取山西醫(yī)科大學(xué)第一臨床醫(yī)學(xué)院2013年10月-2014年12月收治的72例HICH患者,全部患者經(jīng)頭顱CT掃描后診斷,診斷標(biāo)準(zhǔn)符合第四屆腦血管學(xué)術(shù)會(huì)議關(guān)于高血壓腦出血標(biāo)準(zhǔn)。隨機(jī)將72例患者分為觀察組與對(duì)照組兩組,兩組患者在年齡、性別、出血部位、出血量、術(shù)前GCS評(píng)分及發(fā)病至手術(shù)時(shí)間等方面相比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),兩組資料具有可比性。觀察組采用微創(chuàng)穿刺引流術(shù)進(jìn)行治療,對(duì)照組采用開(kāi)顱手術(shù),比較兩組的手術(shù)時(shí)間、術(shù)中出血量、治療有效率、術(shù)后恢復(fù)情況及并發(fā)癥發(fā)生情況。結(jié)果:(1)觀察組平均手術(shù)時(shí)間為(46.54±6.36)min,手術(shù)中平均出血量為(90.50±22.06)ml。對(duì)照組平均手術(shù)時(shí)間為(100.62±8.54)min,手術(shù)中平均出血量為(320.20±35.15)ml。兩組相比較,觀察組手術(shù)時(shí)間及術(shù)中出血量明顯少于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)經(jīng)治療后,觀察組治療有效患者33例,治療總有效率為91.67%。對(duì)照組治療有效患者為26例,治療總有效率為72.22%,兩組相比較,觀察組治療總有效率明顯優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)兩組患者全部隨訪6個(gè)月,分別進(jìn)行ADL評(píng)分評(píng)價(jià)遠(yuǎn)期療效,以(I+II+III)級(jí)為恢復(fù)良好率,兩組相比較,觀察組明顯優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)兩組患者術(shù)后并發(fā)癥情況進(jìn)行統(tǒng)計(jì),微創(chuàng)穿引流術(shù)后并發(fā)癥發(fā)生率為11.11%。開(kāi)顱術(shù)后并發(fā)癥發(fā)生率為33.33%。兩組相比較,觀察組術(shù)后并發(fā)癥發(fā)生率明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)觀察組與對(duì)照組相比,微創(chuàng)穿刺引流術(shù)手術(shù)時(shí)間明顯少于開(kāi)顱手術(shù)組,微創(chuàng)穿刺引流組術(shù)中出血量明顯少于開(kāi)顱手術(shù)組。(2)觀察組與對(duì)照組相比較,微創(chuàng)穿引流術(shù)治療組治療總有效率優(yōu)于開(kāi)顱手術(shù)組。(3)全部患者經(jīng)6個(gè)月隨訪,微創(chuàng)穿刺引流組遠(yuǎn)期療效評(píng)價(jià)優(yōu)于開(kāi)顱手術(shù)組。(4)并發(fā)癥統(tǒng)計(jì)方面,微創(chuàng)穿刺引流組術(shù)后并發(fā)癥明顯少于開(kāi)顱手術(shù)組。
[Abstract]:Objective: to investigate the clinical effect of minimally invasive puncture and drainage for hypertensive intracerebral hemorrhage. The purpose of this study was to compare the clinical efficacy of minimally invasive puncture drainage and craniotomy in the treatment of hypertensive intracerebral hemorrhage and to explore the clinical advantages of minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage in order to better guide the clinical treatment of hypertensive intracerebral hemorrhage. Methods: 72 patients with HICH were selected from October 2013 to December 2014 in the first Clinical Medical College of Shanxi Medical University. All the patients were diagnosed after brain CT scan. The diagnostic criteria met the criteria of the fourth Cerebrovascular academic Conference on hypertensive intracerebral hemorrhage. 72 patients were randomly divided into two groups: observation group and control group. There was no significant difference in age, sex, bleeding site, bleeding volume, preoperative GCS score and time from onset to operation between the two groups (P0.05). The two sets of data are comparable. The observation group was treated with minimally invasive puncture and drainage, and the control group was treated with craniotomy. The operative time, intraoperative blood loss, effective rate of treatment, postoperative recovery and complications were compared between the two groups. Results: (1) the average operative time in the observation group was (46.54 鹵6.36) min,. The average blood loss in the operation was (90.50 鹵22.06) ml.. The average operative time in the control group was (100.62 鹵8.54) min,. The average blood loss in the operation was (320.20 鹵35.15) ml.. Compared with the two groups, the operative time and bleeding volume in the observation group were significantly less than those in the control group (P0.05). (2). After treatment, 33 effective patients in the observation group were treated with a total effective rate of 91.67%. The total effective rate of the two groups was 72.22%. Compared with the two groups, the total effective rate of the observation group was obviously better than that of the control group, the difference was statistically significant (P0.05). (3), all the patients in the two groups were followed up for 6 months. ADL scores were used to evaluate the long-term curative effect. (III) grade was used as the recovery rate. Compared with the two groups, the observation group was obviously superior to the control group. The difference was statistically significant (P0.05). (4). The incidence of complications after minimally invasive drainage was 11.11%. The incidence of complications after craniotomy was 33.33%. Compared with the two groups, the incidence of postoperative complications in the observation group was significantly lower than that in the control group, the difference was statistically significant (P0.05). Conclusion: (1) compared with the control group, the operation time of minimally invasive puncture drainage in the observation group was significantly shorter than that in the craniotomy group, and the amount of bleeding in the minimally invasive puncture drainage group was significantly less than that in the craniotomy group. (2) the observation group was compared with the control group. The total effective rate of minimally invasive puncture drainage group was better than that of craniotomy group. (3) after 6 months follow-up, the long-term curative effect of minimally invasive puncture drainage group was better than that of craniotomy group. (4) the statistics of complications. The postoperative complications in the minimally invasive puncture drainage group were significantly less than those in the craniotomy group.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R651.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 鄧平;吳曉牧;;高血壓腦出血病理生理機(jī)制研究進(jìn)展[J];中華腦血管病雜志(電子版);2010年04期

2 鄭兆聰;趙琳;陳宏頡;高進(jìn)喜;魏梁鋒;張小軍;荊俊杰;王如密;王守森;;高血壓腦出血的個(gè)體化微創(chuàng)治療[J];中國(guó)微侵襲神經(jīng)外科雜志;2006年06期

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