中国全科医学2018，Vol.21Issue(6)：702-706,5.DOI:10.3969/j.issn.1007-9572.2017.00.266
开颅血肿清除术和钻孔引流术治疗中等量基底核区高血压脑出血的临床疗效比较研究
Comparative Study of Clinical Efficacy of Craniotomy and Craniopuncture in Treating Moderate-volume Hypertensive Intracerebral Haemorrhage in Basal Ganglia
摘要
Abstract
Background At present, the most common surgical methods for hypertensive intracerebral haemorrhage (ICH) are haematoma removal by craniotomy and craniopuncture, but controversies exist about the choice of the two surgical methods. Objective To explore a better surgical method, this study was designed to compare clinical efficacy of haematoma removal by craniotomy and craniopuncture in treating moderate-volume (30-60 ml) hypertensive ICH in basal ganglia. Methods A total of 176 patients treated in Harrison International Peace Hospital Affiliated to Hebei Medical University with moderate volume (30-60 ml) hypertensive ICH in basal ganglia from January 2012 to June 2016 were recruited according to the inclusion criteria, including 90 cases of stable ICH and 86 cases of active ICH. The patients of stable ICH and active ICH were respectively divided into stable ICH treated by craniotomy group (group A, n=46) and stable ICH treated by craniopuncture group (group B, n=44), active ICH treated by craniotomy group (group C, n=42) and active ICH treated by craniopuncture group (group D, n=44)in accordance with the random number table. Groups A and C received haematoma removal by craniotomy, and groups B and D underwent craniopuncture. The rebleeding rate after operation, postoperative fatality rate and modified Rankin Scale (mRS) and activities of daily living (Barthel index) at 6 months after admission were compared between group A and group B and between group C and group D. Results There were no significant differences in rebleeding rate after operation, fatality rate, mRS and Barthel index between group A and group B (P>0.05). The rebleeding rate after operation, fatality rate and mRS in group C were lower than those in group D (P<0.05), and the Barthel index was higher than that in group D (P<0.05). Conclusion In patients with moderate-volume hypertensive ICH in basal ganglia, the stable ICH patients can benefit from craniopuncture, which is simple and can reduce surgical injury; for the active ICH patients, haematoma removal by craniotomy is reasonable, which can reduce the postoperative rebleeding rate and fatality rate, and improve prognosis. In view of this, clinical classification is definitely necessary to these patients before operation.关键词
颅内出血/高血压性/稳定性脑出血/活动性脑出血/外科手术/手术后出血/疗效比较研究Key words
Intracranial hemorrhage/hypertensive/Stable intracerebral haemorrhage/Active intracerebral haemorrhage/Surgical procedure/Postoperative haemorrhage/Comparative effectiveness research分类
医药卫生引用本文复制引用
孙昭胜,赵旺淼,葛春燕,张万增,李晓卫..开颅血肿清除术和钻孔引流术治疗中等量基底核区高血压脑出血的临床疗效比较研究[J].中国全科医学,2018,21(6):702-706,5.基金项目
河北省科技计划项目(16277799D) （16277799D）
