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中国人民解放军总医院老年心血管病研究所
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
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钻孔引流术和小骨窗颅内血肿清除术对高血压性基底节区中等量脑出血的疗效和预后对比研究
Comparative study on the curative effect and prognosis of drilling drainage and small window cranial hematoma clearance in the treatment of moderate cerebral hemorrhage in hypertensive basal ganglia
投稿时间:2019-07-19  修订日期:2019-09-05
DOI:
中文关键词:  高血压脑出血;小骨窗;颅内血肿清除术;钻孔引流术;预后
英文关键词:Hypertensive intracerebral hemorrhage; Small bone window; Intracranial hematoma clearance; Borehole drainage; Prognosis
基金项目:项目名称:河池市少数民族高血压病患者高血压防治知识与健康行为相关性的研究
作者单位E-mail
付光辉 象州县人民医院神经外科 ffan7735@126.com 
刘全 柳州市工人医院神经外科 biyly1@163.com 
覃军 柳州市工人医院 akmka4109@sina.com 
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中文摘要:
      目的:探讨对比钻孔引流术和小骨窗颅内血肿清除术对高血压性基底节区中等量脑出血的疗效和预后。方法:选取2016年5月~2018年5月我院收治的84例高血压基底节区中等量脑出血患者作为研究对象,随机将其分为研究组和对照组,每组各42例。研究组患者采用微创钻孔引流术进行治疗,对照组患者则采用小骨窗颅内血肿清除术进行治疗。统计比较两组患者的手术时间、术中出血量、血肿清除率、术后并发症和再出血情况,并采用格拉斯哥预后评分(GOS)、格拉斯哥昏迷评分(GCS)和日常生活能力评级(ADL)进行评价两组患者的预后情况。结果:研究组的手术时间和术中出血量低于对照组,差异有统计学意义(P<0.05),两组患者拔管时的血肿清除率比较,差异无统计学意义(P>0.05)。研究组的肺部感染、消化道出血的发生率要低于对照组,差异有统计学意义(P<0.05),其余并发症和再出血的发生率两组比较,差异无统计学意义(P>0.05)。两组患者术后三周时的GOS和GCS评分无明显差异(P>0.05)。对照组死亡率4.76%,研究组死亡率2.38%,两组比较无统计学意义(P>0.05)。对照组和研究组患者的术后3个月ADL评分优良率分别为78.57%、88.09%,两组比较差异无统计学意义(P>0.05)。结论:小骨窗颅内血肿清除术和钻孔引流术治疗对高血压基底节区中等量脑出血均有较好的疗效,能有效清除血肿,而钻孔引流术相对而言手术时间短,创伤小,并发症少,应用价值更优。
英文摘要:
      Objective:To compare the curative effect and prognosis of drilling drainage and small bone window cranial hematoma clearance in patients with moderate cerebral hemorrhage in hypertensive basal ganglia. Method:From May 2016 to May 2018, 84 patients with moderate intracerebral hemorrhage in hypertensive basal ganglia were selected and divided into study group and control group with 42 cases in each group.The patients in the study group were treated by minimally invasive drilling and drainage, while the patients in the control group were treated by small bone window cranial hematoma clearance.The operative time, intraoperative bleeding volume, hematoma clearance rate, postoperative complications and rebleeding were compared between the two groups. Glasgow prognosis score (GOS), Glasgow coma score (GCS) and activity of Daily living (ADL) were used to evaluate the prognosis of the two groups. Results:The operative time and blood loss in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the clearance rate of hematoma between the two groups during extubation (P > 0.05).The incidence of pulmonary infection and gastrointestinal hemorrhage in the study group was significantly lower than that in the control group (P < 0.05). There was no significant difference in the incidence of other complications and rebleeding between the two groups (P > 0.05).There was no significant difference in GOS and GCS scores between the two groups three weeks after operation (P > 0. 05). The mortality of the control group was 4.76 and that of the study group was 2.38. There was no significant difference between the two groups (P > 0.05).The excellent and good rates of ADL score in the control group and the study group were 78.57 and 88.09, respectively. There was no significant difference between the two groups (P > 0. 05). Conclusion:Small bone window cranial hematoma clearance and drilling drainage are effective in the treatment of moderate cerebral hemorrhage in hypertensive basal ganglia, and can effectively remove hematoma, while drilling drainage is relatively short in operative time, less in trauma and less in complications. The application value is better.
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