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微创穿刺清除术治疗基底节区脑出血60例临床研究(1)
http://www.100md.com 2011年2月25日 杨光
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     [摘要] 目的:比较两种微创穿刺清除术治疗基底节区高血压脑出血的优缺点。方法:回顾性分析60例基底节区高血压脑出血患者,对照组30例,使用硅胶管,治疗组30例,使用YL-1型一次性使用颅内血肿粉碎穿刺针,行微创穿刺清除术治疗,并按神经功能缺损评分标准对两组患者的治疗效果等进行统计分析。结果:两组患者的治疗效果无显著不同。结论:两种方法都可用于基底节区高血压脑出血的治疗,但从血肿抽吸引流的效率角度看,硬通道抽吸术有一定的优势。

    [关键词] 高血压脑出血;微创术;硬通道抽吸术;软通道抽吸术

    [中图分类号] R722.15+1 [文献标识码]A[文章编号]1674-4721(2011)02(c)-041-02

    Clinical study on hypertensive intracerebral hemorrhage in the basal ganglia of 60 cases treated by micro-traumatic operation to clear away hematoma by puncture

    YANG Guang

    (Department of Neurosurgery, Liaoning Provincial Thromus Disease Treatment Center Combining Traditional Chinese Medicine and Western Medicine, Shenyang 110101, China)

    [Abstract] Objective: To compare two surgical advantages and disadvantages on minimally invasive micropuncture treating hypertensive intracerebral hemorrhage in the basal ganglia. Methods: The clinical records of 60 patients with hypertensive intracerebral hemorrhage in the basal ganglia were retrospecively analyzed. 30 patients in control group used silieon rubber hose. 30 patients in treating group used type YL-1 intracranial hematoma comminute biopsy puncture needles. Both groups patients were treated by micro-traumatic operation to clear away hematoma by puncture. Statistic analysis was made on the neurologic deficit standarded scores between control and treating groups. Results: There was no statistic significant difference in the neurologic deficit standarded scores. Conclusion: The both ways can treat hypertensive intracerebral hemorrhage. Hard tunnel aspiration of clots has more advantages in efficiency of aspiration and drainage of hematoma.

    [Key words] Hypertensive intracerebral hemorrhage; Minimally invasive surgery; Hard tunnel aspiration of clots; Soft tunnel aspiration of clots

    高血压脑出血是多发病,起病急,由于急性期占位效应所产生的脑水肿和颅内压增高,导致相当高的病死率,存活者后遗症重。因此,采取手术方式清除血肿,降低颅内压力,减轻脑水肿,以减少血肿引起的继发性脑损害,这对于出血后的脑组织功能恢复将产生积极作用,从而降低急性期的病死率和恢复期的致残率。近年来,随着手术方法的改进和多样化,对高血压脑出血外科治疗的指征有放宽的趋势,微创穿刺清除术近年来被广泛应用。回顾性分析本科2008年1月~2009年1月采用YL-1型一次性使用颅内血肿粉碎穿刺针治疗基底节区高血压脑出血患者30例,并与传统颅骨钻孔留置硅胶引流管方式治疗的基底节区高血压脑出血30例作比较,总结分析如下:

    1 资料与方法

    1.1 一般资料

    所有患者均为本科住院患者,均符合全国第四届脑血管病会议关于脑出血的诊断标准 ......

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