摘要
目的:探讨在高血压脑出血手术治疗中运用去骨瓣减压术的疗效。方法:选取2017年1月-2019年3月本院神经外科收治的高血压脑出血手术患者80例,按随机数字表法分为开颅组和减压组,各40例。开颅组实施传统开颅血肿清除术,减压组实施去骨瓣减压术辅助传统开颅血肿清除术治疗。比较两组患者术后并发症、血清学指标变化状况、神经功能、日常生活能力、运动功能、预后状况。结果:减压组并发症发生率为2.5%,显著低于开颅组的20.0%,差异有统计学意义(P<0.05)。术后1周,减压组血清MMP-9水平低于开颅组,差异有统计学意义(P<0.05)。术后1个月,减压组NIHSS评分显著低于开颅组,Barthel指数、FMA评分均显著高于开颅组,差异均有统计学意义(P<0.05)。术后3个月,减压组预后良好率为87.5%,显著高于开颅组的67.5%,差异有统计学意义(P<0.05)。结论:在高血压脑出血手术治疗中运用去骨瓣减压术辅助可减少并发症,减轻脑损伤,改善预后。
Objective: To investigate the effect of decompressive craniectomy in the treatment of hypertensive intracerebral hemorrhage. Method: A total of 80 patients with hypertensive intracerebral hemorrhage in neurosurgery from January 2017 to March 2019 were selected, according to the random number table, they were divided into craniotomy group and decompression group, 40 cases in each group. The traditional craniotomy hematoma removal was performed in the craniotomy group, and the decompressed group was treated with decompressive craniectomy to assist the traditional craniotomy hematoma removal. Postoperative complications, changes of serological indicators, neurological function, daily living ability, motor function and prognosis of patients in the two groups were compared. Result: The complication rate of the decompression group was 2.5%, significantly lower than 20.0% of the craniotomy group, the difference was statistically significant(P<0.05). 1 week after surgery, serum MMP-9 level in the decompression group was lower than that in the craniotomy group, with statistically significant difference(P<0.05). One month after surgery, NIHSS score of the decompression group was significantly lower than that of the craniotomy group, Barthel index and FMA score were significantly higher than those of the craniotomy group, the differences were statistically significant(P<0.05). Three months after surgery, the prognosis of the decompression group was 87.5%, significantly higher than 67.5% of the craniotomy group, the difference was statistically significant(P<0.05). Conclusion: The use of decompressive craniectomy in the treatment of hypertensive cerebral hemorrhage can reduce complications, reduce brain damage and improve prognosis.
作者
王威
WANG Wei(Xiaogan Hospital,Wuhan University of Science and Technology,Xiaogan 432000,China)
出处
《中国医学创新》
CAS
2019年第32期35-38,共4页
Medical Innovation of China
关键词
高血压脑出血
去骨瓣减压术
开颅血肿清除术
神经功能
预后
Hypertensive cerebral hemorrhage
Decompressive craniectomy
Craniotomy hematoma evacuation
Neurological function
Prognosis
