摘要
目的比较小骨窗开颅术和颅骨钻孔血肿穿刺引流术的临床效果。方法2000年1月～2005年1月，我院将320例高血压脑出血分为小骨窗开颅组（n=178）和颅骨钻孔血肿穿刺引流组（n=142），比较2组术后疗效和残死率。结果引流组手术时间（41．5±26．0）min明显短于开颅组的（126．1±34．0）min（t=-24．482，P=0．000）。术后7d复查CT，血肿完全清除率开颅组（78．1％，139／178）明显高于引流组（59．9％，85／142）（χ^2=12．501，P=0．000），待患者出院时颅内血肿均基本消除。术后1年恢复率（ADLⅠ～Ⅲ级）引流组（73．9％，105／142）与开颅组（78．1％，139／178）无显著性差异（χ^2=0．101，P=0．750）。结论小骨窗开颅术和颅骨钻孔血肿穿刺引流术的临床早期治疗效果理想，开颅术血肿清除率高于引流术，引流术手术时间较短，利于深部血肿的清除。
Objective To compare clinical outcomes between craniotomy via small bone flap and trepanation and drainage for hypertensive intracerebral hemorrhage. Methods A total of 320 cases of hypertensive intracerebral hemorrhage received either craniotomy via small bone flap （ Craniotomy Group, n = 178） or trepanation and drainage （ Drainage Group, n = 142） from January 2000 to January 2005 in this hospital. Postoperative outcomes between the two groups were compared. Results The operation time was significantly shorter in the Drainage Group （41.5 ± 26.0 min） than in the Craniotomy Group （126.1 ± 34.0 min） （t = -24. 482, P = 0. 000）. Re-examinations of CT on the 7 postoperative day showed significantly higher hematoma clearance rate in the Craniotomy Group （78.1% ,139/178） than in the Drainage Group （59.9% ,85/142） （χ^2 = 12.501, P = 0. 000）. There was no significant difference in 1- year recovery rate （ADL grade Ⅰ- Ⅲ） between the Drainage Group （73.9% , 105/142） and the Craniotomy Group （78.1% , 139/178） （χ^2 = 0. 101, P = 0. 750）. Conclusions Both craniotomy via small bone flap and trepanation and drainage offer satisfactory short-term curative effects for hypertensive intracerebral hemorrhage. Craniotomy via small bone flap gives higher hematoma clearance rate than trepanation and drainage does, and the later needs shorter operation time and is more suitable for deep hemorrhage.
出处
《中国微创外科杂志》
CSCD
2006年第8期617-619,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
高血压性脑出血
微创手术
Hypertensive intracerebral hemorrhage
Minimally invasive surgery
