摘要
目的：探讨Toth水解剖技术在经侧裂入路高血压脑出血显微手术中的应用。方法：选取2011年1月-2015年1月本院收治的72例基底节区高血压脑出血患者作为研究对象,按随机数字表法将其分为对照组和观察组,每组36例。对照组行传统经外侧裂入路显微手术,观察组在经外侧裂入路显微手术中应用Toth水解剖技术。比较两组患者术后24 h的血肿清除率、术后并发症发生情况及术后6个月的生存质量。结果：两组术后24 h CT检查结果显示,观察组有27例（75.0%）患者血肿清除率〉95%,81%~95%者7例（19.4%）,≤80%者2例（5.6%）;对照组中血肿清除率〉95%者16例（44.4%）,81%~95%者11例（30.6%）,≤80%者9例（25.0%）,观察组的血肿清除率明显优于对照组,差异有统计学意义（H=17.987,P〈0.001）。观察组术后共出现并发症4例,包括术后再出血、肺部感染各1例,泌尿系统感染2例,发生率为11.1%;对照组共出现并发症15例,包括术后再出血、消化道出血各3例,肺部感染5例,泌尿系统感染4例,发生率为41.7%,观察组的术后并发症发生率明显低于对照组,差异有统计学意义（P〈0.05）。观察组术后6个月ADL评级结果为：ADL1~2级26例（72.2%）,ADL3级6例（16.7%）,ADL4级4例（11.1%）;对照组为：ADL1~2级13例（36.1%）,ADL3级16例（44.4%）,ADL4级7例（19.4%）;观察组的生存质量明显优于对照组,差异有统计学意义（H=19.091,P〈0.001）。结论：在经侧裂入路显微手术中联合应用Toth水解剖技术治疗高血压脑出血的效果显著,血肿清除彻底,手术创伤小,手术效果满意,术后并发症少,生存质量高,可作为一种有效技术在临床加以推广应用。
Objective： To investigate the application of Toth water dissection technique during the microsurgery of transsylvian approach in hypertensive cerebral hemorrhage.Method： 72 patients with hypertensive cerebral hemorrhage at basal ganglia region admitted to our hospital from January 2011 to January 2015 were selected as the research objects, they were divided into the control group and the observation group according to the random number table method, 36 cases in each group.The control group adopted the traditional microsurgery of transsylvian approach and the observation group adopted the Toth water dissection technique during the micro-surgery of transsylvian approach.The clearance rate of hematoma after 24 hours of treatment, postoperative complications and quality of life after 6 months of treatment between the two groups were compared.Result： According to 24 h CT examination results, the observation group had 27 cases （75.0%） with clearance rate that was greater than 95%, 7 cases （ 19.4% ） with clearance rate that was between 81% and 95%, 2 cases （ 5.6% ） with clearance rate that was less than or equal to 80%.The control group had 16 cases （ 44.4% ） with clearance rate that was greater than 95%, 11 cases （ 30.6% ） with clearance rate that was between 81% and 95%, 9 cases （ 25.0% ） with clearance rate that was less than or equal to 80%, the clearance effect of the observation group was better than the control group, the difference was statistically significant（H=17.987, P〈0.001 ） .After treatment, the observation group had 4 cases with complications including 1 case of rebleeding, 1 case of pulmonary infection, 2 cases of urinary system infection, the incidence rate was 11. 1%.The control group had 15 cases with complications including 3 cases of rebleeding, 3 cases of gastrointestinal bleeding, 5 casesof pulmonary infection, 4 cases of urinary system infection, the incidence rate was 41.7%.The incidence rate of the observation group was significantly lower than the control g
出处
《中国医学创新》
CAS
2016年第5期63-66,共4页
Medical Innovation of China
关键词
Toth水解剖技术
经侧裂入路
高血压脑出血
显微手术
Toth water dissection technique
Transsylvian approach
Hypertensive cerebral hemorrhage
Micro-surgery
