CAJ | 학술논문

目的分析高血压脑出血救治中超早期锁孔手术的疗效。方法回顾性分析2010年4月至2012年10月在我院接受外科治疗的高血压脑出血患者的临床资料，依据患者手术方式不同分为观察组(锁孔手术组)和对照组(小骨窗手术组)。比较2组患者手术时间、血肿清除率、术后并发症及神经功能恢复等指标。结果观察组手术时间显著短于对照组(P<0.001)；观察组患者拔管时血肿清除率与对照组患者相比差异无统计学意义(P>0.05)；观察组患者术后并发症显著低于对照组(P<0.05)；观察组术后代谢及电解质紊乱发生率显著低于对照组(P<0.05)；术后28 d观察组患者SSS评分显著高于对照组患者(P<0.05)。观察组患者术后6个月ADL评分优于对照组(P<0.05)。结论高血压脑出血的外科治疗中，锁孔手术与小骨窗手术相比具有术中损伤小、术后并发症及代谢紊乱发生率低、近期及远期(6个月)神经功能恢复良好等优点。
목적분석고혈압뇌출혈구치중초조기쇄공수술적료효。방법회고성분석2010년4월지2012년10월재아원접수외과치료적고혈압뇌출혈환자적림상자료，의거환자수술방식불동분위관찰조(쇄공수술조)화대조조(소골창수술조)。비교2조환자수술시간、혈종청제솔、술후병발증급신경공능회복등지표。결과관찰조수술시간현저단우대조조(P<0.001)；관찰조환자발관시혈종청제솔여대조조환자상비차이무통계학의의(P>0.05)；관찰조환자술후병발증현저저우대조조(P<0.05)；관찰조술후대사급전해질문란발생솔현저저우대조조(P<0.05)；술후28 d관찰조환자SSS평분현저고우대조조환자(P<0.05)。관찰조환자술후6개월ADL평분우우대조조(P<0.05)。결론고혈압뇌출혈적외과치료중，쇄공수술여소골창수술상비구유술중손상소、술후병발증급대사문란발생솔저、근기급원기(6개월)신경공능회복량호등우점。
Objective To analyze the curative effect of super-early keyhole surgery in treatment of hypertensive cerebral hemorrhage. Methods Clinical data of patients with hypertensive cerebral hemorrhage who received treatment in our hospital from April 2010 to October 2012 were retrospectively analyzed. Patients were divided into the observation group ( keyhole surgery group) and the control group ( routine group) by different therapeutic methods. The operation time, rate of hematoma clearance, postoperative complications, and recovery of neu-ral function of the two groups were compared. Results The observation group had a shorter operation time than the control group, and the difference was statistically significant(P<0. 001). There was no singnificant difference between the two groups in rate of hematoma clear-ance at the time of tube drawing(P>0. 05). The observation group had less postoperative complications than the control group, and the difference was statistically significant(P<0. 05). The observation group had a lower rate of metabolic disorders than the control group with a statistically significant difference(P<0. 05). Patients of the observation group had a higher scores of SSS than patients of the control group 28 days after operation, and the difference was statistically significant(P<0. 05). 6 months after operation, the observation group had a bet-ter ADL than the control group, and the difference was statistically significant(P<0. 05). Conclusion Super-early keyhole surgery which has less intraoperative injury, postoperative complication, and metabolic disorders, can achieve a better effect than routine operation. And it is of better neural functional recovery.