四川医学2024，Vol.45Issue(7)：765-769,5.DOI:10.16252/j.cnki.issn1004-0501-2024.07.013
小脑出血不同手术治疗方案的临床对比研究
Clinical Contrastive Research of Cerebellar Hemorrhage by Different Surgical Treatment
袁淼 1翟安林 1肖文峰 1苟志勇 1王帆 1朱黎1
作者信息
- 1. 四川绵阳四○四医院·川北医学院附属第二医院神经外科,四川绵阳 621000
- 折叠
摘要
Abstract
Objective To study clinical effects of cerebellar hemorrhage by different surgical treatment.Methods From January 2018 to January 2022,a retrospective analysis method was adopted.60 cerbellar hemorrhage patients were choosed.Crani-otomy group had 20 patients who accepted hematoma clearance by craniotomy through suboccipital bone flap,keyhole group had 20 patients who accepted hematoma clearance by keyhole through small bone window approach,puncture group had 20 patients who accepted hematoma clearance by soft channel puncture and catheter drainage.Operative time,the amount of intraoperative bleed-ing,the amount of postoperative residual hematoma in the operative area,the number of postoperative rebleeding,the amount of postoperative complications,hospitalization days and ICU time were observed.Glasgow coma scale(GCS),National Institutes of Health Stroke Scale(NIHSS)before and 7 days after surgery,and Glasgow Outcome Scale(GOS)after 6 months after surgery were recorded.Results GCS and NIHSS scores of 3 groups were significantly improved 7 days after surgery(P＜0.05).Craniotomy group and keyhole group were better than puncture group(P＜0.05).Keyhole group were better than craniotomy group(P＜0.05).GOS scores of 3 groups had no difference(P＞0.05).Operative time and intraoperative hemorrhage in puncture group was better than craniotomy group and keyhole group(P＜0.05),which in keyhole group was better than craniotomy group(P＜0.05).Postoperative residual hematoma and the number of postoperative rebleeding in puncture group were more than those in craniotomy group and keyhole group(P＜0.05).The amount of postoperative complications in keyhole group was smaller than craniotomy group and puncture group(P＜0.05).The hospitalization days and ICU time in keyhole group were fewer than craniotomy group and puncture group(P＜0.05),which in craniotomy group was fewer than that in puncture group(P＜0.05).Conclusion In clinical practice,surgical methods should be selected according to the specific conditions of patients with cerebellar hemorrhage.If conditions permit,it is preferred to clear the hematoma by keyhole through small bone window approach under neuroendoscope or microscope,short-term effects,hospitalization days and ICU time are better than craniotomy or puncture and catheter drainage.关键词
小脑出血/清除血肿/开颅/锁孔/穿刺Key words
cerebellar hemorrhage/hematoma clearance/craniotomy/keyhole/puncture分类
医药卫生引用本文复制引用
袁淼,翟安林,肖文峰,苟志勇,王帆,朱黎..小脑出血不同手术治疗方案的临床对比研究[J].四川医学,2024,45(7):765-769,5.
