【作者】 段威；

【导师】 吴全理；

【作者基本信息】 广西医科大学 ， 神经外科， 2010， 硕士

【摘要】 目的:回顾分析小骨窗开颅经侧裂入路显微手术与钻孔经颞叶微创穿刺引流术两种手术方法治疗高血压基底节区出血的疗效,探讨其临床应用价值。方法:收集广西医科大学第九附属医院神经外科2007年10月至2009年7月手术治疗的60例高血压基底节区出血患者的临床资料,按照手术方式不同分为二组:小骨窗开颅经外侧裂人路显微镜下清除血肿30例(经侧裂组)和钻孔经颞叶微创穿刺抽吸30例(微创穿刺组)。比较两组病人在病死率,术后再出血率等并发症及近远期生活质量改善率方面的差异。结果:经侧裂组30例中死亡4例,无术后再出血;微创穿刺组30例死亡5例,术后再出血1例,术后血肿清除率经侧裂组优于微创穿刺组,两组在病死率、再出血率及术后并发症等临床疗效优良率方面无统计学差异,改善幸存者近远期生活质量方面经侧裂组优于微创穿刺引流组。结论:对于基底节区30-60mL内中等量出血患者小骨窗开颅经外侧裂显微血肿清除术能够有效提高患者的近远期预后。更多还原

【Abstract】 Objective To evaluate and compare the effectiveness of different types of surgical therapy for patients with hypertensive intracerebral hemorrhage, and summarize the clinical experience.Methods A total of 60 cases with hypertensive intracerebrel hemorrhage hospitalized in Beihai 1st hospital from Oct 2007 to July 2009 were subjected in this study .They were divided into 2 groups according to operation method: Group I (n=30),receiving craniotomy with small bone flap via lateral fissure and Group II (n=30)receiving CT guided minimal invasive hematoma aspiration .All data were analyzed retrospectively.Result The case fatality, rehaemorrhage rate and the incidence of postoperative complication in group I were 13%,0%,30%respectively. The case fatality ,rehaemorrhage rate and the incidence of postoperative complication in group II were 25%,3.3%,39%. There was no significant statistical difference between the two groups. As for Their GOS fitneness and score of activities of daily living(ADL)were investigated during the 6 months’close follow up, GOS and ADL in group I is much higher than the other one.Conclusion To hypertensive cerebral hemorrhage in basal ganglion with operative indication,especially whose volume of hematoma is between 30-60ml,the microsurgery treatment by small skull fenestral is a safe and efective way.更多还原