摘要
目的观察脑立体定向超早期微创冲水法手术治疗高血压脑出血对血肿清除率、GCS评分及ADL分级的影响。方法采用前瞻性随机双盲对照法,将2014年6月至2017年6月唐山市第三医院收治的60例高血压脑出血患者采用简单随机分组法随机分为两组:对照组(n=30)行常规开颅术,观察组(n=30)行脑立体定向超早期微创冲水法手术。比较两组患者的血肿清除率、手术时间、术中出血量、住院时间以及术后并发症发生情况,同时观察两组患者术前、术后1周后GCS评分以及随访6个月时的ADL分级情况。结果观察组患者的血肿清除率、手术时间、术中出血量、住院时间均显著优于对照组(P <0. 05);观察组患者的术后再出血、消化道出血、肺部感染、颅内感染等并发症的发生率均低于对照组(P <0. 05);两组患者的术后1周GCS评分均较术前显著升高(P <0. 05),但观察组术后1周GCS评分低于对照组(P <0. 05);术后6个月,观察组ADL分级(Ⅰ～Ⅲ级)高于对照组(P <0. 05)。结论脑立体定向超早期微创冲水法手术治疗高血压脑出血创伤小、并发症少、疗效显著,具有较高的临床应用价值。
Objective To observe the effect of intracerebral hemorrhage,hematoma clearance,GCS and ADL scores in treatment of hypertensive intracerebral hemorrhage by intracerebral stereotactic ultra early minimally invasive surgery.Methods A prospective randomized double-blind control study had been carried out in this hospital during June 2014 to June 2017,60 cases of hypertensive cerebral hemorrhage were randomly divided into two groups by using simple random grouping method:,patients in control group(n=30)underwent conventional craniotomy and patients in observation group(n=30)underwent stereotactic ultra early minimally invasive surgery compared with these two groups of water jetting.Patients with hematoma removal rate,operating time,amount of bleeding,duration of hospitalization and incidence of postoperative complications,and to observe patients in these two groups before and 1 week after GCS ADL grading scores and 6 months follow-up.Results The hematoma clearance rate,operating time,bleeding volume and hospitalization time in patients of observation group were significantly better than those of patients in control group(P<0.05);the observation group of patients with postoperative bleeding,gastrointestinal bleeding,pulmonary infection,intracranial infection and the incidence of complications in patients of observation group were lower than those of control group(P<0.05).Patients in these two groups in 1 week after operation,GCS scores were significantly higher than those before operation(P<0.05).GCS scores in patients of observation group after 1 week snd GCS scores were lower than those of control group(P<0.05).Six months after surgery,ADL grades(I^III)in patients of observation group were higher than those of control group(P<0.05).Conclusion Cerebral stereotactic ultra early minimally invasive surgery for hypertensive intracerebral hemorrhage has less trauma,fewer complications and significant curative effect.It has higher significance for clinical application.
作者
郑冀
张秀萍
李君辉
窦建胜
霍焱
ZHENG Ji;ZHANG Xiu-ping;LI Jun-hui(Department of Cerebral Surgery, Tangshan No.3 Hospital, Tangshan Hebei 063100, China)
出处
《临床和实验医学杂志》
2019年第1期85-88,共4页
Journal of Clinical and Experimental Medicine
基金
河北省卫计委科研项目(编号:20150826)
关键词
高血压脑出血
脑立体定向
超早期
微创冲水法
开颅术
预后
并发症
Hypertensive cerebral hemorrhage
Stereotactic orientation
Super early
Minimally invasive flushing method
Open-brain surgery
Prognosis
Complications
