| 摘要: |
| ［摘要］ 目的 探讨颅内血肿微创清除术治疗高血压脑出血的临床疗效。方法 将210例高血压脑出血患者按治疗方法的不同，分为颅内血肿微创清除术组（手术组）156例和内科保守治疗组（保守组）54例，两组患者给予常规治疗，包括吸氧、保持呼吸道通畅，用速尿或甘露醇消除脑水肿和降颅压，用硫酸镁、硝普钠或尼莫地平控制血压，预防感染和消化道出血、肾功能衰竭等并发症，维持水电解质平衡等。手术组在此基础上行颅内血肿微创清除术。比较观察两组的临床疗效、并发症发生率及病死率。结果 手术组疗效显著优于对照组（P<0.01），手术组并发症发生率和病死率比对照组显著减少（P<0.01）；手术时机≤6 h者的临床疗效显著优于7～12 h手术者（P<0.05）。结论 采用颅内血肿微创清除术治疗高血压脑出血，显著提高基本治愈率，有效降低并发症发生率和病死率，尤其是手术时机≤6 h者的临床疗效更佳。 |
| 关键词: 高血压 脑出血 颅内血肿 微创清除术 |
| DOI：10.3969/j.issn.1674-3806.2010.12.33 |
| 分类号:R 743.34 |
| 基金项目: |
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| Analysis on curative effect of micro-traumatic evacuation of intracranial hematomas in treatment of patients with hypertensive cerebral hemorrhage |
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HE Shen-liu
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Department of Neurosurgery,Dongxing City People′s Hospital, Guangxi 538100,China
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| Abstract: |
| ［Abstract］ Objective To explore the clinical curative effect of micro-traumatic evacuation of intracranial hemotomas in the treatment of patients with hypertensive cerebral hemorrhage.Methods According to different treatment,210 patients with hypertensive cerebral hemorrhage were divided into group of micro-traumatic evacuation of intracranial hematomas (surgical group; n=156) and medical conservative group (conservative group; n=54).The patients in two groups were treated by conventional treatment including oxygen inhalation, maintenance of airway patency, use of furosemide or mannitol for elimination of edema and lowering blood pressure, use of magnesium sulfate, nitroprusside or nimodipine for controlling blood pressure, prevention of complications such as infection, gastrointestinal bleeding and renal failure and so on. On above basis, the surgical group received micro-traumatic evacuation of intracranial hematomas. The clinical curative effect, complication rate and mortality were compared between two groups.Results The curative effect of surgical group was better than that of conservative group(P<0.01);the complication rate and mortality of surgical group were significantly reduced than those of conservative group(P<0.01);the clinical effects in the patients undergoing surgery within 6 hours of onset were better than those in the patients undergoing surgery between 7 and 12 hours of onset(P<0.05).Conclusion Use of micro-treatment in patients with hypertensive cerebral hemorrhage can significantly increase the basic cure rate, effectively reduce complication rate and mortality. In particular, its cure effects is better for the patients undergoing surgery within 6 hours of onset. |
| Key words: Hypertension Cerebral hemorrhage Intracranial hematomas Micro-traumatic evacuation |
