高血压脑出血立体定向穿刺与内科保守治疗的临床比较分析

发布时间：2018-01-23 23:09

本文关键词： 立体定向高血压脑出血保守治疗住院时间治疗费用　出处：《中国神经精神疾病杂志》2013年10期 　论文类型：期刊论文

【摘要】：目的比较立体定向穿刺引流与内科保守治疗高血压脑出血20~30mL时(hypertensive intracerebral hemorrhage,HICH)的住院费用、时间及疗效。方法回顾性分析2010年3月至2012年12月我院92例高血压脑出血患者,出血量20~30mL,一组为立体定向穿刺引流治疗,一组为内科保守治疗,比较两组的住院时间、费用、出院时及3个月随访神经功能障碍率(主要为肢体瘫痪)及恢复结果。结果立体定向穿刺引流组平均住院时间(14.4±8.3)d,内科保守治疗组(24.5±14.1)d(P0.05),在住院费用上,前组(26296.28±5292.12)元,后组(31769.48±6342.83)元(P0.05),在GOS预后上,出院时立体定向穿刺引流组恢复良好39例、恢复较差5例,无开颅手术治疗病例;内科保守治疗组分别为30、18例,其中2例因脑水肿重行开颅手术;3个月随访,立体定向穿刺引流组生活自理23例、轻度偏瘫16例、中重度5例,内科保守治疗组分别为20、8、20例(u=2.499,P0.05)。立定定向穿刺引流组在上述方面较内科保守治疗组具有优势(P0.05)。结论立体定向穿刺引流治疗幕上高血压脑出血20~30mL时,可缩短住院时间、降低费用、预后更佳,较内科保守治疗有更好的近期及远期疗效。
[Abstract]:Objective to compare the effect of stereotactic puncture and drainage on hypertensive intracerebral hemorrhage (EICH) (20 ~ 30 mL). Hypertensive intracerebral hemorrhage. Methods 92 patients with hypertensive intracerebral hemorrhage from March 2010 to December 2012 were retrospectively analyzed. One group was treated by stereotactic puncture and drainage, the other group was treated with conservative medical treatment. The hospitalization time and cost of the two groups were compared. Results the average hospitalization time of stereotactic puncture drainage group was 14.4 卤8.3 days. In the conservative treatment group, the cost of hospitalization was 26296.28 卤5292.12 yuan. In the posterior group (31769.48 卤6342.83), the prognosis of GOS was good in 39 cases and poor in 5 cases in stereotactic puncture drainage group. No craniotomy; There were 30 cases in the conservative treatment group, among which 2 cases underwent craniotomy because of cerebral edema. After 3 months follow-up, 23 cases of self-care, 16 cases of mild hemiplegia and 5 cases of moderate and severe degree were found in the stereotactic puncture drainage group, and 20 cases in the conservative treatment group. Compared with the conservative treatment group, the stereotactic puncture drainage group has the advantage of P0.050.Conclusion Stereotactic puncture drainage for hypertensive intracerebral hemorrhage of supratentorial hypertension (20? 30 mL). It can shorten the hospital stay, reduce the cost, have better prognosis, and have better short-and long-term effect than conservative medical treatment.
【作者单位】：重庆医科大学附属第一医院;
【基金】：“国家临床重点专科建设项目经费资助”(编号:财社[2011]170号)
【分类号】：R651.1
【正文快照】： 高血压脑出血是神经外科常见的急症之一,病残率、死亡率极高,出血量、治疗时间及方法均极大的影响患者预后,目前尚缺乏统一规范的治疗手段。近年立体定向技术应用于神经外科临床工作,为高血压脑出血微创治疗开辟了新途径。立体定向穿刺引流治疗高血压脑出血,可改善高血压脑出

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