岭南现代临床外科
嶺南現代臨床外科
령남현대림상외과
LINGNAN MODERN CLINICS IN SURGERY
2014年
2期
195-198
,共4页
高血压脑出血%微创穿刺术%小骨窗%疗效
高血壓腦齣血%微創穿刺術%小骨窗%療效
고혈압뇌출혈%미창천자술%소골창%료효
Hypertensive cerebral hemorrhage%Minimally invasive puncture%Small bone flap craniotomy%Curative effect
目的：比较早期微创穿刺引流术与小骨窗血肿清除术治疗基底节区高血压脑出血的临床疗效。方法回顾性分析98例高血压性基底节区脑出血患者临床资料，根据资料，按不同的手术方法分为微创穿刺引流术（微创组，n＝63例）和小骨窗开颅血肿清除术（小骨窗组，n＝35例），评价两组患者手术和住院时间、意识障碍恢复时间、治疗1个月时神经功能缺损程度（NID）和3个月时日常生活活动能力（ADL）。结果微创组手术时间和住院天数显著短于小骨窗组，意识恢复时间无显著性差异；而1个月后微创组患者的NID 明显低于小骨窗组（P＜0．05）；治疗3个月后随访，患者 ADL 达自理水平的较好状态者（Barthel 指数≥80），两组有显著性差异（P＜0．05），微创组优于小骨窗组。结论与小骨窗组相比，微创穿刺术可明显缩短高血压基底节区脑出血患者的手术时间和住院时间，，改善神经功能缺失程度。
目的：比較早期微創穿刺引流術與小骨窗血腫清除術治療基底節區高血壓腦齣血的臨床療效。方法迴顧性分析98例高血壓性基底節區腦齣血患者臨床資料，根據資料，按不同的手術方法分為微創穿刺引流術（微創組，n＝63例）和小骨窗開顱血腫清除術（小骨窗組，n＝35例），評價兩組患者手術和住院時間、意識障礙恢複時間、治療1箇月時神經功能缺損程度（NID）和3箇月時日常生活活動能力（ADL）。結果微創組手術時間和住院天數顯著短于小骨窗組，意識恢複時間無顯著性差異；而1箇月後微創組患者的NID 明顯低于小骨窗組（P＜0．05）；治療3箇月後隨訪，患者 ADL 達自理水平的較好狀態者（Barthel 指數≥80），兩組有顯著性差異（P＜0．05），微創組優于小骨窗組。結論與小骨窗組相比，微創穿刺術可明顯縮短高血壓基底節區腦齣血患者的手術時間和住院時間，，改善神經功能缺失程度。
목적：비교조기미창천자인류술여소골창혈종청제술치료기저절구고혈압뇌출혈적림상료효。방법회고성분석98례고혈압성기저절구뇌출혈환자림상자료，근거자료，안불동적수술방법분위미창천자인류술（미창조，n＝63례）화소골창개로혈종청제술（소골창조，n＝35례），평개량조환자수술화주원시간、의식장애회복시간、치료1개월시신경공능결손정도（NID）화3개월시일상생활활동능력（ADL）。결과미창조수술시간화주원천수현저단우소골창조，의식회복시간무현저성차이；이1개월후미창조환자적NID 명현저우소골창조（P＜0．05）；치료3개월후수방，환자 ADL 체자리수평적교호상태자（Barthel 지수≥80），량조유현저성차이（P＜0．05），미창조우우소골창조。결론여소골창조상비，미창천자술가명현축단고혈압기저절구뇌출혈환자적수술시간화주원시간，，개선신경공능결실정도。
Objective To evaluate the curative effect between early minimally invasive craniopuncture drainage and small bone flap craniotomy for removing the hematoma in hypertensive cerebral hemorrhage. Methods The clinical data of 98 patients with hypertensive basal ganglia hemorrhage were retrospectively analyzed. The patients were divided into minimally invasive hematoma removal surgery group (minimally invasive group, n=63 cases) and small bone flap craniotomy hematoma removal group (small bone flap craniotomy group, n=35 cases). Operation time, hospitalization stay and awareness recovery of patients were evaluated. The neurologic deficit (NID) and the activities of daily living (ADL) were measured at 1 and 3 months after operation respectively. Results The operation time and hospitalization stay in minimally invasive group were less than that in small bone flap craniotomy group. No statistical difference was observed in the time of awareness recovery of patients between two groups. One month after treatment , the NID of minimally invasive group was significantly lower than that of the small bone flap craniotomy group. The patient self-care ADL of minimally invasive group was better than that of the small bone flap craniotomy group at the third month. Conclusion Minimally invasive puncture has an advantage over small bone flap craniotomy in the operation time , hospitalization stay , reduction of neurological deficit and recovery of daily living activities.
