摘要
目的探讨锁孔手术治疗基底节区高血压脑出血的疗效及适应证。方法观察34例经锁孔及显微镜或内镜下血肿清除术(锁孔组)患者的再出血率、术后病死率(术后48h内)和远期(术后6个月)随访结果,与40例传统开颅血肿清除术(传统组)患者相比较。结果锁孔组患者术后再出血发生率较传统组显著降低,手术病死率两组相似。锁孔术组病情Ⅱ、Ⅲ级患者远期预后优于传统组,差异有显著性。Ⅳ、Ⅴ级患者远期预后两组间差异无显著性。结论显微镜或内镜辅助下锁孔血肿清除术有助于降低术后再出血发生率,手术创伤小,能更好地保护神经功能,在轻症患者(病情分级Ⅱ、Ⅲ)能获得较好的预后,有良好应用前景。
Objective To explore the therapeutic effects and indications of micro-keyhole approach in the treatment of hypertensive cerebral hemorrhage. Methods Micro-keyhole approach （MK） was used in 34 patients and traditional craniotomy （TC） in 40 patients. Rehaemorrhagia rate, 48-hour mortality after surgical treatment, and long-term follow-up （ 〉 6 month after operation） were compared between the two methods. Results A significant lower rehaemorrhagia rate was found in the MK group comparing to the TC group, but mortality was similar. The long-term follow-up of patients with pathogenetic condition grading Ⅱ to Ⅲ in the MK group was significant better than that in the traditional craniotomy group, but there was no obvious difference between patients with pathogenetic condition grading Ⅳ-Ⅴ. Conclusion MK is helpful to reduce postoperative rehaemorrhagia rate, with smaller invasion, better protection in neurologic function and better prognosis in mild （ Ⅱ -Ⅲ ） patients.
出处
《中华急诊医学杂志》
CAS
CSCD
2005年第11期931-933,共3页
Chinese Journal of Emergency Medicine
