摘要
目的探讨三种不同术式对自发性脑出血患者的临床疗效、神经功能以及预后的影响。方法选取2009年1月至2011年12月就诊的自发性脑出血患者,按照术式不同分为锥颅血肿引流术组(A组)、小骨瓣开窗微创血肿清除术组(B组)以及颞部或颞顶枕部直切口钻孔引流术组(C组),观察手术前后临床疗效,术后神经功能评价以及预后随访效果。结果 A、B、C组总有效率分别为65.71%、95.00%和87.50%,差异具有统计学意义(P<0.05),A组无效率、术后水肿及住院时间显著高于B组、C组(P<0.05);三组患者在术后NIHSS评分、BI评分以及评分能级方面(Ⅰ级、Ⅱ级)比较,术后NIHSS评分A组最高,BI评分B组最高,评分能级Ⅰ级、Ⅱ级患者比率B组和C组明显高于A组,差异具有统计学意义(P<0.05);各组患者预后良好比率(mRS<4分)明显高于预后不良比率(P<0.05),其中B、C组预后良好比率显著高于A组(P<0.05),Kaplan Meier法标明,A组患者累积致残率显著高于B组、C组(P<0.05)。结论小骨瓣开窗微创血肿清除术对自发性脑出血的神经功能影响小,预后较好,其次为颞部或颞顶枕部头皮直切口钻孔引流术,值得临床推广应用。
Objective To investigate the clinical efficacy of three difihrent surgical procedures on patients with spontaneous intracerebral hemorrhage, function and afihet the nervous prognosis. Methods From January 2009 to December 2011 in patients with spontaneous intraeerebral hemorrhage, according to difihrent surgical drainage, were divided into skull hematoma group （A） , Small bone window hematoma array of minimally invasive （ group B ） and temporal incision straight drainage drilling hematoma （ group C ）. Clinical efficacy, postoperative neurologie evaluation and prognosis of follow - up results were observed before and after surgery. Results The total efficiency of A, B, C group was respectively 65.71%, 95.00% and 87.50% ,there was significant difference（ P 〈0.05 ）, inefficiency, postoperative edema and hospital stay of group A were significantly higher than those of group B and group C （ P 〈 0.05） ; NIHSS score of patients after surgery in group A was highest, BI score in group B was the highest, score - level aspects （ I grade, grade 11 ） in group B and C were higher than group A, and it had statistically signifi- cant difference （ P 〈 0.05）. Good prognosis groups ratio （ mRS 〈4 rain） was significantly higher than the ratio of poor prognosis （ P 〈 0.05 ）. Prognosis good ratio in group B and C were significantly higher than that in group A （ P 〈 0.05 ） , Kaplan Meier method indicated, A group of pa- tients was significantly higher than the cumulative disability group B, group C （ P 〈 0.05 ）. Conclusion Small bone window hematoma array of minimally invasive has small influence on neurological function of spontaneous patients. The prognosis is good and it is worthy of promotion.
出处
《临床和实验医学杂志》
2016年第14期1404-1407,共4页
Journal of Clinical and Experimental Medicine
关键词
自发性脑出血
锥颅血肿引流术
小骨瓣开窗微创血肿清除术
颞部或颞顶枕部直切口钻孔引流术
神经功能
预后
Different operation
Drainage into skull hematoma
Small bone window hematoma array of minimally invasive
Temporal incision straight drainage drilling hematoma
Neurological function
Prognosis
