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《顱內(nèi)血腫微創(chuàng)穿刺清除術(shù)治療重癥高血壓性腦出血的療效分析.pdf》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、中南醫(yī)學(xué)科學(xué)雜志2014年5月第42卷第3期271文章編號：2095—1116(2014)03—0271—03·臨床醫(yī)學(xué)·顱內(nèi)血腫微創(chuàng)穿刺清除術(shù)治療重癥高血壓性腦出血的療效分析鞏學(xué)磊(衡陽市中心醫(yī)院神經(jīng)內(nèi)科，湖南衡陽421001)摘要：目的探討顱內(nèi)血腫微創(chuàng)穿刺清除術(shù)治療重癥高血壓性腦出血的療效。方法回顧性分析重癥高血壓腦出血患者的臨床資料，其中采用微創(chuàng)顱內(nèi)血腫清除治療為微創(chuàng)組，開顱手術(shù)治療為小骨窗組，比較兩組的臨床療效。結(jié)果術(shù)后第1天小骨窗組血腫量顯著少于微創(chuàng)組(P<0．01)，但術(shù)后3天和7天，兩組血腫量比較沒有差異(P>0．05)。
2、兩組術(shù)后NIHSS評分、臨床療效、GOS評分比較，差異無統(tǒng)計學(xué)意義(P>0．05)，微創(chuàng)組肺部感染顯著低于小骨窗組，住院時間顯著短于小骨窗組(P<0．01)。結(jié)論顱內(nèi)血腫微創(chuàng)穿刺清除術(shù)治療高血壓性腦出血安全可行，適應(yīng)證較寬，可明顯改善患者預(yù)后及生活質(zhì)量，值得臨床推廣應(yīng)用。關(guān)鍵詞：顱內(nèi)血腫；穿刺清除術(shù)，微創(chuàng)；重癥高血壓腦出血中圖分類號：R743．34文獻(xiàn)標(biāo)識碼：AEficacyAnalysisofSevereHypertensiveIntracerebralHemorrhageTreatedbySmashedIntracranialHem
3、atomaByMicroTraumaticPunctureGONGXuelei(DepartmentofNeuology，HengyangCentralHospital，Hengyang，Hunan421001，China)Abstract：ObjectiveToanalysetheefficacyofseverehypertensiveintracerebralhemorrhagetreatedbysmashedintracranialhematomabymicrotraumaticpuncture．MethodsFrom2009Ja
4、nuaryto2012January，clinicaldataof90caseswithseverehypertensivecerebralhemorrhagepatientswereananlyzed．Casestreatedbysmashedintracranialhemato-mabymicrotraumaticpunctureweretheminimallyinvasivegroup，andcasestreatedbysmallbonewindowcraniotomywerethegroupofsmallbonewindow．T
5、herapeuticeffectswerecompared．ResultsHematomavolumeofgroupofsmallbonewindowwassmallerthanthatofminimallyinvasivegroupatonedayafteroperation(P<0．01)．Volumeofhematomashowednosignificantdifferencebetweentwogroupsat3dayand7dayafteroperation(P>0．05)．NIHSS，clinicalefficacyandG
6、OSoftwogroupshadnosignificantdifference(P>0．05)．Pulmonaryinfectionratesofminimallyinvasivegroupwaslowerthanthatofgroupofsmallbonewindow，andhospitalstaywasshorterthanthatofgroupofsmallbonewindow(P<0．01)．ConclusionSmashedintracranialhematomabymicrotraumaticpuncturetreatmen
7、tofseverehypertensivein—tracerebralhemorrhageissafeandfeasible，withrelativelywiderrangeofindications，significantlyimprovestheprognosisandqualityoflife，whichisworthyofclinicalapplication．Keywords：smashedintracranialhematoma；microtraumaticpuncture；severehypertensiveintrace
8、rebralhemorhage重癥高血壓腦出血是指CT檢查腦實質(zhì)內(nèi)出血者中線結(jié)構(gòu)移位大于1cm的腦出血，病死率高達(dá)量大于50mL或哥拉斯哥評分(GCS)小于8分或90％以上，目前治療方法主要有微創(chuàng)顱內(nèi)血腫清
