中国实用神经疾病杂志
中國實用神經疾病雜誌
중국실용신경질병잡지
Chinese Journal of Practical Nervous Diseases
2015年
22期
4-5
,共2页
微创%血肿清除术%老年%高血压脑出血
微創%血腫清除術%老年%高血壓腦齣血
미창%혈종청제술%노년%고혈압뇌출혈
Minimally invasive%Hematoma%Elderly%Hypertensive cerebral hemorrhage
目的：分析微创颅内血肿清除术治疗老年高血压脑出血的临床疗效。方法选取2011‐07—2014‐07在我院接受治疗的血肿量在30～100 m L的高血压脑出血手术患者180例，随机分为观察组与对照组，每组各90例。2组均给予常规的内科支持治疗，包括吸氧、降血压、降颅压、止血、预防并发症及抗感染等治疗。存在梗阻性脑积水者均采用侧脑室穿刺引流，有气管切开指征者均予以气管切开。在此基础上，观察组给予微创颅内血肿清除术，对照组给予开颅血肿清除术。结果观察组痊愈21例，显效29例，有效25例，无效15例，治疗有效率为83.33％；对照组痊愈13例，显效21例，有效22例，无效34例，治疗有效率为62.22％。观察组治疗有效率明显高于对照组，差异具有统计学意义（ P＜0.05）。治疗1个月后，观察组NIHSS评分为（6.2±1.7）分，BI评分为（85.43±11.21）分；对照组 NIHSS评分为（9.6±2.5）分，BI评分为（67.54±10.22）分。治疗后观察组NIHSS评分明显低于对照组，BI评分明显高于对照组，差异具有统计学意义（P＜0.05）。结论微创颅内血肿清除术治疗老年高血压脑出血的临床效果显著，值得推广。
目的：分析微創顱內血腫清除術治療老年高血壓腦齣血的臨床療效。方法選取2011‐07—2014‐07在我院接受治療的血腫量在30～100 m L的高血壓腦齣血手術患者180例，隨機分為觀察組與對照組，每組各90例。2組均給予常規的內科支持治療，包括吸氧、降血壓、降顱壓、止血、預防併髮癥及抗感染等治療。存在梗阻性腦積水者均採用側腦室穿刺引流，有氣管切開指徵者均予以氣管切開。在此基礎上，觀察組給予微創顱內血腫清除術，對照組給予開顱血腫清除術。結果觀察組痊愈21例，顯效29例，有效25例，無效15例，治療有效率為83.33％；對照組痊愈13例，顯效21例，有效22例，無效34例，治療有效率為62.22％。觀察組治療有效率明顯高于對照組，差異具有統計學意義（ P＜0.05）。治療1箇月後，觀察組NIHSS評分為（6.2±1.7）分，BI評分為（85.43±11.21）分；對照組 NIHSS評分為（9.6±2.5）分，BI評分為（67.54±10.22）分。治療後觀察組NIHSS評分明顯低于對照組，BI評分明顯高于對照組，差異具有統計學意義（P＜0.05）。結論微創顱內血腫清除術治療老年高血壓腦齣血的臨床效果顯著，值得推廣。
목적：분석미창로내혈종청제술치료노년고혈압뇌출혈적림상료효。방법선취2011‐07—2014‐07재아원접수치료적혈종량재30～100 m L적고혈압뇌출혈수술환자180례，수궤분위관찰조여대조조，매조각90례。2조균급여상규적내과지지치료，포괄흡양、강혈압、강로압、지혈、예방병발증급항감염등치료。존재경조성뇌적수자균채용측뇌실천자인류，유기관절개지정자균여이기관절개。재차기출상，관찰조급여미창로내혈종청제술，대조조급여개로혈종청제술。결과관찰조전유21례，현효29례，유효25례，무효15례，치료유효솔위83.33％；대조조전유13례，현효21례，유효22례，무효34례，치료유효솔위62.22％。관찰조치료유효솔명현고우대조조，차이구유통계학의의（ P＜0.05）。치료1개월후，관찰조NIHSS평분위（6.2±1.7）분，BI평분위（85.43±11.21）분；대조조 NIHSS평분위（9.6±2.5）분，BI평분위（67.54±10.22）분。치료후관찰조NIHSS평분명현저우대조조，BI평분명현고우대조조，차이구유통계학의의（P＜0.05）。결론미창로내혈종청제술치료노년고혈압뇌출혈적림상효과현저，치득추엄。
Objective To analyze the clinical efficacy of minimally invasive removal of intracranial hematoma in elderly pa‐tients with hypertensive cerebral hemorrhage.Methods 180 cases with hypertensive intracerebral hemorrhage with the hemato‐ma volume varying from 30 mL to 100 mL in our hospital from July 2011 to July 2014 were randomly divided into observation group and control group ,90 cases in each group. All patients were treated with conventional medical treatment including oxy‐gen inhalation ,blood pressure reduction ,intracranial pressure reduction ,bleeding control ,complications precaution and anti‐infection therapy. Based on the above‐mentioned therapy ,patients in the observation group were treated by minimally invasive removal of intracranial hematoma.Results In the observation group ,21 cases were completely cured ,significantly improved in 29 cases ,and improved in 25 cases ,ineffective in 15 cases ,with the effective rate of 83.33% .In the control group ,13 cases were cured ,significantly effective in 21 cases ,effective in 22 cases ,ineffective in 34 cases ,with the effective rate of 62.22%. Obviously ,the observation group had higher efficiency than control group and the difference was statistically significant (P<0.05). After one month treatment ,NIHSS scores were (6.2 ± 1.7) points and BI scores were (85.43 ± 11.21) points in the observation group;while NIHSS scores were (9.6 ± 2.5) points and BI scores were (67.54 ± 10.22) points in the control group. Notably ,the observation group got higher NIHSS scores and lower BI scores than the control group with statistically significant differences (P<0.05).Conclusion The effect of minimally invasive removal of intracranial hematoma is remarkable in elderly patients with hypertensive cerebral hemorrhage ,which should be worthy of promotion.
