两种手术方法治疗高血压脑出血的效果观察.docVIP

两种手术方法治疗高血压脑出血的效果观察 　　浙江省兰溪市人民医院神经外科，浙江兰溪 321100 　　[摘要] 目的 比较开颅血肿清除术和钻孔血肿引流术治疗高血压脑出血（HICH）的临床效果。 方法 138例HICH患者随机分为开颅组和钻孔组，分别接受开颅血肿清除术和钻孔血肿引流术，评价两组患者术后并发症、术后6个月的神经功能状况和日常生活能力（ADL）。 结果 开颅组肺部感染、再出血和死亡的发生率明显高于钻孔组，差异均具有统计学意义（P 0.05）；术后6个月两组ADL经Kappa检验显示差异具有统计学意义（P 0.05）；开颅组停留ICU时间和住院时间明显长于对照组，治疗费用明显高于对照组，差异均具有统计学意义（P 0.05）。 结论 钻孔血肿引流术能明显降低HICH患者术后的并发症，改善日常生活能力，降低治疗费用。 　　[关键词] 开颅血肿清除术；钻孔血肿引流术；高血压脑出血；日常生活能力；神经功能缺损 　　[中图分类号] R743.34 [文献标识码] A [文章编号] 1673-7210（2013）11（b）-0066-03 　　Effect observation of two methods for hypertensive intracerebral hemorrhage 　　SUN Liyang 　　Department of Neurosurgery， the Peoples Hospital of Lanxi City， Zhejiang Province， Lanxi 321100， China 　　[Abstract] Objective To compare the effects of craniotomy and minimally invasive trepanation and drainage for hypertensive intracerebral hemorrhage （HICH）. Methods 138 cases with HICH were randomly divided into craniotomy group and trepanation group， and they were treated with craniotomy and minimally invasive trepanation and drainage respectively. The postoperative complications， neurological conditions after 6 months， and activity of daily living （ADL） were compared between the two groups. Results The incidences of lung infection， rebleeding and death in craniotomy group were obviously higher than those in trepanation group， the difference was statistically significant （P 0.05）； the ADL after 6 months tested by Kappa in the two groups was found had statistically significant difference （P 0.05）； the time of ICU stay， hospital stay， and costs in the two groups had statistical difference （P 0.05）. Conclusion Minimally invasive trepanation and drainage can decrease the postoperative complications， improve the activity of daily living and reduce the costs in the treatment for HICH. 　　[Key words] Craniotomy； Minimally invasive trepanation and drainage； Hypertensive intracerebral hemorrhage； Activity of daily living； Neurologic impairment 　　高血压脑出血（hypertensive intracerebral hemorrhage， HICH）