摘要
目的:比较经皮层入路与经侧裂入路显微镜下血肿清除术对高血压脑出血(HICH)的疗效。方法:队列研究。抽取2018年6月至2023年6月咸阳市第一人民医院收治的78例HICH患者,按随机数字表法分为对照组和观察组,每组39例。对照组采用经皮层入路显微手术治疗,观察组采用经侧裂入路显微手术治疗。比较两组治疗效果。结果:观察组手术与住院时间短于对照组,出血量少于对照组(P<0.05)。术前,两组血肿、水肿程度比较差异未见统计学意义(P>0.05);术后,观察组血肿、水肿程度低于对照组(P<0.05)。术前,两组美国国立卫生研究院卒中量表(NIHSS)评分比较差异未见统计学意义(P>0.05);术后,观察组NIHSS评分低于对照组,Glasgow预后评分高于对照组(P<0.05)。观察组并发症发生率(10.26%,4/39)低于对照组(38.46%,15/39),P<0.05。结论:经侧裂入路显微手术治疗HICH能更有效清除血肿,改善患者神经功能,且并发症发生率更低。
Objective:To compare the efficacy of microscopic hematoma removal surgery through transcortical approach and transsylvian approach in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods:This study was a cohort study.Seventy-eight HICH patients admitted to the First People’s Hospital of Xianyang from June 2018 to June 2023 were selected,and they were divided into a control group and an observation group using a random number table method,with 39 cases in each group.The control group was treated by microscopic hematoma removal surgery through transcortical approach,and the observation group was treated by microscopic hematoma removal surgery through transsylvian approach.The treatment efficacy of the two groups were compared.Results:The observation group had shorter surgical time,shorter hospital stay and less intraoperative bleeding compared with the control group(P<0.05).There was no statistically significant difference in the degree of hematoma and edema between the two groups before operation(P>0.05).After operation,the degree of hematoma and edema in the observation group was lower than that in the control group(P<0.05).There was no difference in the American National Institute of Health stroke scale(NIHSS)score between the two groups before operation(P>0.05).After operation,the observation group had a lower NIHSS score,and a higher Glasgow outcome scale score compared with the control group(P<0.05).The incidence of complications in the observation group(10.26%,4/39)was lower than that in the control group(38.46%,15/39),P<0.05.Conclusions:Microscopic hematoma removal surgery through transsylvian approach in the treatment of HICH can more effectively remove hematoma and improve neurological function,with lower incidence of complications.
作者
王安帮
董发达
Wang Anbang;Dong Fada(Department of Neurosurgery,the First People's Haspital of Xianyang,Xianyang 712000,China)
出处
《中国实用医刊》
2024年第13期32-34,共3页
Chinese Journal of Practical Medicine
关键词
高血压脑出血
显微镜
血肿清除术
Intracranial hemorrhage,hypertensive
Microscope
Hematoma removal surgery
