摘要
目的研究微创穿刺颅内血肿清除术及开颅血肿清除术治疗高血压脑出血的疗效。方法回顾性分析苏州大学附属第一医院急诊外科2013年1月至2018年2月收治的136例高血压脑出血手术患者的资料。将患者按手术方式分成两组,微创穿刺组66例患者行颅内血肿微创穿刺清除术,对照组70例患者行开颅血肿清除术。观察手术并发症及患者住院时间、住院费用、术后生活质量,并评定治疗效果。结果微创穿刺组患者术后有效率明显高于对照组,差异有统计学意义(P <0. 05)。微创穿刺组患者的平均手术时间、术中出血量、平均住院天数及手术费用均明显低于对照组(均P <0. 05);而术后并发症的发生率则明显低于对照组(P <0. 05)。结论颅内血肿微创穿刺清除术是治疗高血压脑出血行之有效的方法,相对于开颅血肿清除术而言,其手术时间短、住院费用少、患者术后并发症少、生活质量高,值得在临床推广应用。
Objective To compare the efficacy of minimally invasive removal of intracranial hematoma and evacuation of hematoma by craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 136 patients with hypertensive cerebral hemorrhage who treated in our department from January 2013 to February 2018 were analyzed retrospectively. 136 patients were divided into two groups according to the surgical method：66 cases of hypertensive cerebral hemorrhage underwent minimally invasive surgery with hematoma evacuation as the experimental group ,70 cases of hypertensive cerebral hemorrhage underwent open craniotomy with hematoma evacuation as the control group. The operative complications, hospitalization time, hospitalization expenses, postoperative quality of life and curative effect were observed between the two groups. Results The average hospitalization time, hospitalization expenses and postoperative quality of life of the experimental group were statistically significant lower compared with those of routine craniotomy （ P 〈 0.05 ）. The incidence of rebleeding, reoperation, incision infection, cerebrospinal fluid leakage and intracranial infection in the surgical area of craniotomy hematoma removal was significantly higher than that in the experimental group （ P 〈 0.05 ）. Conclusions Minimally invasive removal of intracranial hematoma is an effective method for the treatment of hypertensive intracerebral hemorrhage. Compared with the removal of craniotomy hematoma, the time of hospitalization is short, the cost of hospitalization is less, and the patient＇s quality of life is high. It is worthy of clinical application.
作者
陈雄辉
张鹏杰
唐梅峰
徐峰
周幽心
凌伟华
CHEN Xiong-hui;ZHANG Peng-jie;TANG Mei-feng;LING Wei-hua(Department of Emergency Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Corresponding author)
出处
《临床神经外科杂志》
CAS
2018年第5期341-345,共5页
Journal of Clinical Neurosurgery
基金
江苏省高校自然科学研究面上项目(16KJB320007)
江苏省自然科学基金(青年基金项目)(BK20140297)
江苏省青年医学人才资助项目(QNRC2016724)
苏州市科技局民生科技项目医疗卫生应用基础研究(SYSD2017076)
关键词
高血压脑出血
立体定向
开颅术
微创外科
hypertensive cerebral hemorrhage
stereotactic
craniotomy
minimally invasive surgery
