CAJ | 학술논문

目的探讨立体定向联合显微手术治疗丘脑高血压脑出血的疗效,探寻治疗丘脑高血压脑出血的最佳手术方法. 方法选择兴义市人民医院神经外科自2009年10月至2011年3月收治的丘脑高血压脑出血患者43例,根据手术方式不同分为立体定向联合显微手术治疗的观察组(22例)及直接进行外科手术的对照组(21例).比较2组患者术前、术后1周、术后1月CT下血肿情况,以及术后1月临床疗效和术后3月日常生活能力(ADL)评分分级. 结果血肿变化情况比较显示,观察组术后1周及1月时血肿量与对照组比较差异有统计学意义(P＜0.05).临床疗效比较显示,观察组疗效明显高于对照组(观察组平均秩次为18.022,对照组平均秩次为26.166),差异有统计学意义(P＜0.05)；观察组总有效率为77.3％.对照组总有效率为52.4％,比较差异有统计学意义(P＜0.05).术后ADL评分分级比较显示,观察组ADL评分明显优于对照组(观察组平均秩次为18.363,对照组平均秩次为25.809),差异有统计学意义(P＜0.05).术后并发症比较显示,观察组并发症发生率为22.7％.对照组并发症发生率为42.8％.比较差异有统计学意义(P＜0.05). 结论立体定向联合显微手术治疗丘脑高血压脑出血可有效改善生存质量,并发症少,值得临床推广应用.
목적 탐토입체정향연합현미수술치료구뇌고혈압뇌출혈적료효,탐심치료구뇌고혈압뇌출혈적최가수술방법. 방법 선택흥의시인민의원신경외과자2009년10월지2011년3월수치적구뇌고혈압뇌출혈환자43례,근거수술방식불동분위입체정향연합현미수술치료적관찰조(22례)급직접진행외과수술적대조조(21례).비교2조환자술전、술후1주、술후1월CT하혈종정황,이급술후1월림상료효화술후3월일상생활능력(ADL)평분분급. 결과 혈종변화정황비교현시,관찰조술후1주급1월시혈종량여대조조비교차이유통계학의의(P＜0.05).림상료효비교현시,관찰조료효명현고우대조조(관찰조평균질차위18.022,대조조평균질차위26.166),차이유통계학의의(P＜0.05)；관찰조총유효솔위77.3％.대조조총유효솔위52.4％,비교차이유통계학의의(P＜0.05).술후ADL평분분급비교현시,관찰조ADL평분명현우우대조조(관찰조평균질차위18.363,대조조평균질차위25.809),차이유통계학의의(P＜0.05).술후병발증비교현시,관찰조병발증발생솔위22.7％.대조조병발증발생솔위42.8％.비교차이유통계학의의(P＜0.05). 결론 입체정향연합현미수술치료구뇌고혈압뇌출혈가유효개선생존질량,병발증소,치득림상추엄응용.
Objective To explore the clinical outcomes of patients with hypertensive intracerebral hemorrhage in the thalamus received stereotactic combined with microsurgical treatment,and find the best treated method. Methods Forty-three patients with hypertensive intracerebral hemorrhage in the thalamus,admitted to our hospital from October 2009 to March 2011,were selected in our study; these patients were divided into stereotactic combined with microsurgical treatment group (observation group,n=22) and direct surgery group (control group,n=21).Preoperative hematoma,and hematoma at 1 week and 1 month after the treatments under CT were compared; clinical curative effect at 1 month after the treatments and activities of daily living (ADL) 3 months after the treatments were compared. Results The hematoma in the observation group 1 week and 1 month after the treatments was statistically different as compared with that in the control group (P＜0.05).Clinical curative effect in the observation group (average rank=18.022) was better than that in the control group (26.166) with significant differences (P＜0.05); the total effective rate in the observation group was 77.3％ and that in the control group was 52.4％ with significant differences (P＜0.05).ADL scale indicated that the ability of the observation group (average rank=18.363) were better than that in the control group (25.809) with significant differences (P＜0.05).The postoperative complication rate in the observation group (22.7％) was lower than that in the control group (42.8％) with significant differences (P＜0.05). Conclusion Stereotactic combined with microsurgical treatment in patients with hypertensive intracerebral hemorrhage in the thalamus is safe and effective; this treatment can improve the postoperative living quality and enjoy few complications,which is worth in the clinical application.