CT下血肿穿刺引流术在高血压脑出血中的应用

发布时间：2018-02-28 03:42

本文关键词： 高血压脑出血 CT定位下血肿穿刺抽吸引流术预后　出处：《皖南医学院》2015年硕士论文　论文类型：学位论文

【摘要】：目的：高血压脑出血(Hypertensive intracerebral hemorrhage HICH)发病率高,致死及致残率也高。目前,采用外科手术治疗高血压脑出血,成了最重要的冶疗方式之一。手术治疗方式可选性比较多,手术方式的选择是有效治疗的关键所在。本研究目的是探讨CT定位下血肿穿刺抽吸引流术治疗高血压脑出血的临床效果,为治疗提供依据。方法：回顾性分析我院150例高血压脑出血以手术治疗为主的患者,并分为三组,分别采用小骨窗开颅血肿清除及CT定位下血肿穿刺抽吸引流术和传统大骨瓣开项血肿清除术各50例,采用统计学方法从以下两个方面对比研究：三组术后1个月死亡率情况、术后6个月三组ADL(activity of daily living scal)分级疗效情况。结果：1、3个治疗组病人在术前年龄、GCS评分、血肿量大小方面差异无统计学意义(P0.05)。2、显示病人在术后一个月后死亡率3个组没有显著差异(P0.05)。3、 CT定位下血肿穿刺抽吸引流术后6个月ADL分级疗效优于小骨窗开项血肿清除术组及传统大骨瓣开颅血肿清除术,两者有统计学差异(P0.05)。4、小骨窗开颅血肿清除术组及传统大骨瓣开颅血肿清除术组术后6个月ADL分级疗效之间无统计学差异(P0.05)。结论：常见三种高血压脑出血手术治疗方法比较：CT定位下血肿穿刺抽吸引流术在提高日常生活能力方面优于小骨窗开颅血肿清除术及传统大骨瓣开颅血肿清除术,但从患者术后1月死亡率方面比较无明显差异。
[Abstract]:Objective: the incidence of hypertensive intracerebral hemorrhage HICH is high, and the rate of death and disability is also high. At present, surgical treatment of hypertensive intracerebral hemorrhage has become one of the most important treatment methods. The purpose of this study was to investigate the clinical effect of hematoma aspiration and drainage under CT localization in the treatment of hypertensive intracerebral hemorrhage. Methods: 150 patients with hypertensive intracerebral hemorrhage were analyzed retrospectively and divided into three groups. 50 patients were treated with small bone window craniotomy, 50 patients with hematoma aspiration and drainage under CT localization and 50 cases with traditional large bone flap hematoma removal. The mortality of the three groups was compared from the following two aspects: 1 month mortality in the three groups. Results the ADL(activity of daily living in the three treatment groups were evaluated at the preoperative age, and the patients in the three treatment groups were treated with ADL(activity of daily living grade at 6 months after operation. There was no significant difference in hematoma volume between the three groups after one month of operation (P 0.05). There was no significant difference in the mortality rate among the three groups after one month of operation. The ADL grading effect of hematoma aspiration and drainage under CT localization was better than that of small bone window opening blood. Excision group and traditional large bone flap craniotomy and hematoma removal, There was significant difference between the two groups (P0.05. 4). There was no statistical difference between the small bone window craniotomy group and the traditional large bone flap craniotomy group. Conclusion: three common types of hypertensive intracerebral hemorrhage were treated by operation. Methods compared with the small bone window craniotomy and the traditional large bone flap craniotomy, the aspiration and drainage of hematoma were better than the small bone window craniotomy and the traditional large bone flap craniotomy. However, there was no significant difference in postoperative mortality in January.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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