【作者】 张岩睿；

【导师】 栾新平；

【作者基本信息】 新疆医科大学 ， 外科学， 2010， 硕士

【摘要】 目的：比较微创穿刺血肿抽吸术联合尿激酶治疗与小骨窗开颅血肿清除术治疗高血压脑出血的疗效优劣。方法：入选病人根据随机原则分成两组,并取得患者或其家属同意,一组使用YL-1进行微创穿刺治疗高血压脑出血,术后联合使用尿激酶2万单位,每日一次血肿腔内给药,并持续引流；另一组采用小骨窗开颅血肿清除术,直接清除血肿。结果：两组患者在NIHSS评分和3个月预后GOS评分上的差异无统计学意义,但微创穿刺具有创伤小、治疗效果与开颅组相同、住院时间短、并发症少等优点。结论：在预后无明显差异情况下,选择住院时间短,创伤小,易于开展的治疗方法。对于血肿量在30-60m1的基底节区脑出血患者,选择微创穿刺血肿抽吸术,优于小骨窗开颅治疗。对于血肿量较大,有生命体征紊乱的患者,如果医院具备开颅手术条件,进行开颅手术,可以尽快解除颅高压,有效控制病情发展速度。更多还原

【Abstract】 Objective:To compare the curative effect of minimally invasive treatment of hematoma aspiration combined urokinase therapy and the small bone window hematoma evacuation for hypertensive cerebral hemorrhage merits.Methods:The selected patients which were permitted by their families were randomly divided into two groups based on the screening principles. One group using the YL-1 hematoma puncture needle for minimally invasive treatment of hypertensive cerebral hemorrhage, after the operation administrated 2 ten- thousand units urokinase into hematoma cavity daily. the other taking hematoma evacuation with a small bone window in order to remove the hematoma. Results:There was no significant difference in the NIHSS score and 3-month outcome on the GOS score, but minimally invasive with less trauma, shorter hospital stay, fewer complications and the same treatment effect compared with the craniotomy group. Conclusion:If there is no significant difference in the final prognosis of the case, try to select the shorter length of stay, less invasive, easy to carry out the treatment. Selecting the minimally invasive treatment in the supratentorial intracerebral hematoma of 30 60ml volume patients, is better than the treatment of small bone window craniotomy. To the larger amount of hematoma volume with life disorders patients, craniotomy can be lifted intracranial hypertension as soon as possible and controlled the rate of progression of the disease effectively if the hospital conditions were permitted.更多还原