摘要
目的：比较小骨窗显微血肿清除术与穿刺外引流术治疗基底节脑出血的临床效果。方法92例高血压基底节出血患者按照数字表法随机分为两组，A组46例，B组46例，A组采用小骨窗显微血肿清除术，B组采用穿刺外引流术。比较两组手术情况，并发症及血清S100β蛋白。结果两组患者均顺利完成手术，A组手术时间、术中出血量、住院时间分别为（125．3±29．1）min、（84．3±11．4）mL、（14．2±2．7）d，B组分别为（70．5±15．4）min、（39．6±9．6）mL、（8．1±1．9）d，A组均明显高于B组（t＝3．724、8．162、2．996，P＜0．05，P＜0．01）。A、B两组分别有11例、3例发生呼吸道感染，A组发生率明显高于B组（χ2＝9．12，P＜0.05）；A、B两组分别有0例、3例发生再出血，0例、2例发生脑疝；B组再出血、脑疝发生率明显高于A组（χ2＝4．76、4．18，均P＜0．05）。术后1个月时B组1例患者由于再发脑出血死亡，A组术后3个月患者按ADL分级治疗良好率为93．5％，B组术后3个月患者按ADL分级治疗良好率为82．6％，两组比较，差异有统计学意义（χ2＝5．06，P＜0．05）。术后1d、7d、14dA组血清S100β蛋白分别为（3．17±0．62）μg／L、（1．52±0．41）μg／L、（1.26±0．33）μg／L；B组血清S100β蛋白分别为（2．38±0．52）μg／L、（2．09±0．53）μg／L、（1．31±0．34）μg／L，术后1dA组血清S100β蛋白明显高于B组（t＝2．812，P＜0．05）；术后7dA组血清S100β蛋白明显低于B组（t＝2．620，P＜0．05）；术后14d两组血清S100β蛋白差异无统计学意义（t ＝1．082， P ＞0．05）。结论小骨窗显微血肿清除术和穿刺外引流术治疗基底节脑出血各有优缺点，应根据患者病情采取不同的治疗方式。
Objective To compare microsurgery through small skull window hematoma puncture and external drainage in the treatment and clinical effect of basal ganglia hemorrhage.Methods 92 cases of hypertensive basal ganglia hemorrhage were randomly divided into the two groups,46 cases in each group,A group was used microsurgery through small skull window hematoma,group B by puncture drainage.Operation time,complications and serum S100 protein of two groups were compared.Results Two groups were successfully completed operation,operation time, amount of bleeding,the time of hospitalization in A group were （125.3 ±29.1）min,（84.3 ±11.4）mL,（14.2 ± 2.7）d,B group were （70.5 ±5.4）min,（39.6 ±9.6）mL,（8.1 ±1.9）d,A group were significantly higher than that of group B （t =3.724,8.162.2.996,P 〈0.05,P 〈0.01 ）.A,B two groups had respectively 11 cases,3 cases of respiratory tract infection,A group was significantly higher than that of group B （χ2 =9.12,P 〈0.05 ）.0 case, 3 cases occurred in rebleeding in group A and B,respectively,0 cases,2 cases occurred cerebral hernia in group A and B,respectively,rebleeding,cerebral hernia in group B was significantly higher than that in group A （χ2 =4.76, 4.18,all P 〈0.05）.1 patient because of recurrent cerebral hemorrhage was dead after operation in group B,group A after operation in patients with good treatment in three months according to ADL classification rate was 93.5%,B group after operation in patients with good treatment in three months according to ADL classification rate was 82.6%, the difference was statistically significant （χ2 =5.06,P 〈0.05）.After 1D,7d,14d in serum of S100 beta protein in group A were （3.17 ±0.62）μg/L,（1.52 ±0.41）μg/L,（1.26 ±0.33）μg/L;group B beta protein of serum S100 were （2.38 ±0.52）μg/L,（2.09 ±0.53）μg/L,（1.31 ±0.34）μg/L.1d beta protein of serum S100 in group A was significantly higher than group B （t =2.812,P 〈0.05）;postoperative serum 7d S100 beta protein in group A w
出处
《中国基层医药》
CAS
2015年第10期1540-1543,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
脑出血
手术
治疗结果
Cerebral Hemorrhage
Operation
Treatment Outcome
