现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
19期
2887-2888,2891
,共3页
颅内出血,高血压性/治疗%血肿/治疗%清创术%体层摄影术,X线计算机
顱內齣血,高血壓性/治療%血腫/治療%清創術%體層攝影術,X線計算機
로내출혈,고혈압성/치료%혈종/치료%청창술%체층섭영술,X선계산궤
Intracranial hemorrhage,hypertensive/therapy%Hematoma/therapy%Debridement%Tomography,X-ray computed
目的：探讨在CT引导下颅内血肿微创清除术治疗高血压性脑出血的临床疗效。方法选择2009年1月至2010年12月在该科住院且明确诊断为脑出血患者80例，随机分为微创组和常规组，各40例。微创组患者在CT定位下运用YL-1型颅内粉碎穿刺针行血肿清除术，常规组患者仅采用常规治疗。比较分析两组患者好转率、病死率及死亡原因，对两组存活患者术后3个月采用日常生活能力量表（ADL）和Barthel指数评分评定致残率。结果微创组存活率（85.0%）明显高于常规组（60.0%），病死率（15.0%）明显低于常规组（40.0%），且致残率（14.7%）较常规组（41.7%）明显下降，差异均有统计学意义（χ2=5.234、6.270、4.417，P=0.022、0.012、0.036）。两组患者死亡原因主要为发生脑疝，共7例（微创组3例、常规组4例）。结论 CT引导下的颅内血肿微创清除术是治疗高血压性脑出血的一种有效手段，具有创伤小、对手术环境要求低的特点，适宜在基层医院开展应用，可降低脑出血的病死率和致残率，提高存活患者的日常生活能力。
目的：探討在CT引導下顱內血腫微創清除術治療高血壓性腦齣血的臨床療效。方法選擇2009年1月至2010年12月在該科住院且明確診斷為腦齣血患者80例，隨機分為微創組和常規組，各40例。微創組患者在CT定位下運用YL-1型顱內粉碎穿刺針行血腫清除術，常規組患者僅採用常規治療。比較分析兩組患者好轉率、病死率及死亡原因，對兩組存活患者術後3箇月採用日常生活能力量錶（ADL）和Barthel指數評分評定緻殘率。結果微創組存活率（85.0%）明顯高于常規組（60.0%），病死率（15.0%）明顯低于常規組（40.0%），且緻殘率（14.7%）較常規組（41.7%）明顯下降，差異均有統計學意義（χ2=5.234、6.270、4.417，P=0.022、0.012、0.036）。兩組患者死亡原因主要為髮生腦疝，共7例（微創組3例、常規組4例）。結論 CT引導下的顱內血腫微創清除術是治療高血壓性腦齣血的一種有效手段，具有創傷小、對手術環境要求低的特點，適宜在基層醫院開展應用，可降低腦齣血的病死率和緻殘率，提高存活患者的日常生活能力。
목적：탐토재CT인도하로내혈종미창청제술치료고혈압성뇌출혈적림상료효。방법선택2009년1월지2010년12월재해과주원차명학진단위뇌출혈환자80례，수궤분위미창조화상규조，각40례。미창조환자재CT정위하운용YL-1형로내분쇄천자침행혈종청제술，상규조환자부채용상규치료。비교분석량조환자호전솔、병사솔급사망원인，대량조존활환자술후3개월채용일상생활능역량표（ADL）화Barthel지수평분평정치잔솔。결과미창조존활솔（85.0%）명현고우상규조（60.0%），병사솔（15.0%）명현저우상규조（40.0%），차치잔솔（14.7%）교상규조（41.7%）명현하강，차이균유통계학의의（χ2=5.234、6.270、4.417，P=0.022、0.012、0.036）。량조환자사망원인주요위발생뇌산，공7례（미창조3례、상규조4례）。결론 CT인도하적로내혈종미창청제술시치료고혈압성뇌출혈적일충유효수단，구유창상소、대수술배경요구저적특점，괄의재기층의원개전응용，가강저뇌출혈적병사솔화치잔솔，제고존활환자적일상생활능력。
Objective To approach the clinical efficacy of CT-guided micro-traumatic operation for intracranial hematoma in treatment of hypertensive cerebral hemorrhage. Methods A total of 80 patients diagnosed with intracerebral hem-orrhage in this hospital received from Jan. 2009 to Dec. 2010 were selected and divided into the micro-invasive group and the normal-care group, 40 cases in each group. The patients in the micro-invasive group were operated with microinvasive surgery by YL-1 intracranial smash needle under CT-positioning hematoma(MTG) while the patients in the normal-care group with the con-ventional therapy. A comparative analysis of the improvement rate,mortality and morbidity as well as cause of death of the two groups was conducted. A disability rate was assessed for the survivals according to ADL and Barthel indicators after postoperative 3 months. Results The survival rate (85.0%) of the micro-invasive group was significantly higher than that (60.0%) of the nor-mal-care group. The mortality(15%) of the micro-invasive group was lower than that(40.0%)of the normal-care group with statical significance(χ2=5.234,6.270,4.417,P=0.022,0.012,0.036). The causes of death in the both groups mainly were the relapsing hemorrhage(7 cases in total including 3 from the micro-invasive group and 4 from the normal-care group). Conclusion CT-guided micro-traumatic operation for intracranial hematoma is an effective mean of treating hypertensive intracerebral hemorrhage ,being characterized with less trauma,and low demand to the surgical environment,which is suitable for grass-roots hospitals to reduce mortality and disability rates of cerebral hemorrhage morbidity and improve their activities of daily living.
