现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2015年
1期
36-39
,共4页
高血压%脑出血%基底神经节疾病%穿刺术%外科手术,微创性%死亡原因%预后%去骨瓣减压术
高血壓%腦齣血%基底神經節疾病%穿刺術%外科手術,微創性%死亡原因%預後%去骨瓣減壓術
고혈압%뇌출혈%기저신경절질병%천자술%외과수술,미창성%사망원인%예후%거골판감압술
Hypertension%Cerebral hemorrhage%Basal ganglia diseases%Punctures%Surgical procedures,mini-mally invasive%Cause of the death%Prognosis%Decompressive craniectomy
目的：比较分析微创穿刺术与去骨瓣减压术治疗高血压基底节区脑出血疗效及并发症。方法选择该院2011年10月至2013年10月收治的基底节区脑出血患者120例，均为高血压患者，将其随机分成微创穿刺术组和去骨瓣减压术组各60例。比较分析两组患者住院时间、疗效及并发症发生情况。结果与术前比较，两组患者术后美国国立卫生研究院卒中量表（NIHSS）评分均降低，差异有统计学意义（P＜0.01）。与去骨瓣减压术组比较，微创穿刺术组患者平均住院时间缩短，总有效率提高，病死率降低，差异均有统计学意义（P＜0.05）。治疗3个月时，微创穿刺术组患者日常生活能力（ADL）达自理水平良好状态的比例高于去骨瓣减压术组，差异有统计学意义（P＜0.05）。两组并发症发生情况比较，微创穿刺术组继发性癫痫发生率、再出血发生率低于去骨瓣减压术组，差异均有统计学意义（P<0.05）；而肺部感染、肾衰竭、多器官功能衰竭、消化道出血、脑心综合征、水电解质紊乱等严重并发症发生率比较，差异均无统计学意义（P>0.05）。结论微创穿刺术治疗基底节区脑出血疗效优于去骨瓣减压术，加强对上述并发症的防治，可降低其病死率。
目的：比較分析微創穿刺術與去骨瓣減壓術治療高血壓基底節區腦齣血療效及併髮癥。方法選擇該院2011年10月至2013年10月收治的基底節區腦齣血患者120例，均為高血壓患者，將其隨機分成微創穿刺術組和去骨瓣減壓術組各60例。比較分析兩組患者住院時間、療效及併髮癥髮生情況。結果與術前比較，兩組患者術後美國國立衛生研究院卒中量錶（NIHSS）評分均降低，差異有統計學意義（P＜0.01）。與去骨瓣減壓術組比較，微創穿刺術組患者平均住院時間縮短，總有效率提高，病死率降低，差異均有統計學意義（P＜0.05）。治療3箇月時，微創穿刺術組患者日常生活能力（ADL）達自理水平良好狀態的比例高于去骨瓣減壓術組，差異有統計學意義（P＜0.05）。兩組併髮癥髮生情況比較，微創穿刺術組繼髮性癲癇髮生率、再齣血髮生率低于去骨瓣減壓術組，差異均有統計學意義（P<0.05）；而肺部感染、腎衰竭、多器官功能衰竭、消化道齣血、腦心綜閤徵、水電解質紊亂等嚴重併髮癥髮生率比較，差異均無統計學意義（P>0.05）。結論微創穿刺術治療基底節區腦齣血療效優于去骨瓣減壓術，加彊對上述併髮癥的防治，可降低其病死率。
목적：비교분석미창천자술여거골판감압술치료고혈압기저절구뇌출혈료효급병발증。방법선택해원2011년10월지2013년10월수치적기저절구뇌출혈환자120례，균위고혈압환자，장기수궤분성미창천자술조화거골판감압술조각60례。비교분석량조환자주원시간、료효급병발증발생정황。결과여술전비교，량조환자술후미국국립위생연구원졸중량표（NIHSS）평분균강저，차이유통계학의의（P＜0.01）。여거골판감압술조비교，미창천자술조환자평균주원시간축단，총유효솔제고，병사솔강저，차이균유통계학의의（P＜0.05）。치료3개월시，미창천자술조환자일상생활능력（ADL）체자리수평량호상태적비례고우거골판감압술조，차이유통계학의의（P＜0.05）。량조병발증발생정황비교，미창천자술조계발성전간발생솔、재출혈발생솔저우거골판감압술조，차이균유통계학의의（P<0.05）；이폐부감염、신쇠갈、다기관공능쇠갈、소화도출혈、뇌심종합정、수전해질문란등엄중병발증발생솔비교，차이균무통계학의의（P>0.05）。결론미창천자술치료기저절구뇌출혈료효우우거골판감압술，가강대상술병발증적방치，가강저기병사솔。
Objective To compare and analyze the effect and the complications of mini-invasive puncture and decom-pressive craniectomy in treatment of hypertensive basal ganglia hemorrhage. Methods A total of 120 patients with basal ganglid hemorrhage of this hospital from October 2011 to October 2013 were randomly divided into the mini-invasive puncture group (60 cases) and the decompressive craniectomy group(60 cases). The effect and the complications of the two groups were compared and analyzed. Results Compared to pre-operation,the patients′NIHSS socres of the two groups after the operation decreased,which had statistical significance in difference(P<0.01). Compared with the decompressive craniectomy group,it was shorter in average hospitalization time,higher in overall effectiveness,and lower in fatality rate for the patients in the mini-invasive puncture group (P<0.05). At the time of treatment for 3 months,the proportion of those the ADL self-care level reached good conditions in the mini-invasive puncture group was higher than that in the decompressive craniectomy group (P<0.05). Referred to complications,the occurrence of secondary epilepsy and recurrent postoperative hemorrhage in the mini-invasive puncture group was lower than that in the decompressive craniectomy group(P<0.05). There were no statistical significant difference in pulmonary infection,renal fail-ure,multiple organ failure,upper gastrointest bleeding,cerebrocardiac syndrome,water-electrolyte disturbances(P>0.05). Conclu-sion The mini-invasive puncture treatment is superior than decompressive craniectomy in treatment of hypertensive basal gan-glia hemorrhage in clinic effect. It shall be available to reduce fatality rate by strengthening the prevention of complications.
