利用CTA“点状征”指导中等量高血压脑出血手术方式的选择

发布时间：2018-06-16 12:50

  本文选题：CTA点状征 + 高血压基底节区脑出血　； 参考：《国际神经病学神经外科学杂志》2017年05期

【摘要】：目的根据CTA"点状征"是否存在对脑出血分类,研究开颅血肿清除术和钻孔引流术治疗中等量(30ml~60 ml)高血压基底节区脑出血的疗效,探讨手术方式的选择。方法选择中等量高血压基底节区脑出血166例,根据是否存在CTA"点状征"分为两类。每种类型的脑出血再次随机分为两组,分别行开颅血肿清除术和钻孔引流术治疗。比较CTA"点状征"阳性及阴性病例经过不同手术方式治疗后的再出血率、死亡率、发病后90d的改良Rankin评分(mRS)及日常生活能力评分(Barthel指数),对两种手术方式进行评价,探讨中等量脑出血手术方式的选择。结果对于CTA"点状征"阳性病例,钻孔引流术组的再出血率、死亡率均高于开颅手术组(P0.05),生活依赖性比例(mRS2)及预后良好比例(Barthel指数≥90)的差异无统计学意义。对于CTA"点状征"阴性病例,两组的再出血率、死亡率、生活依赖性比例及预后良好比例的差异均无统计学意义。结论对于CTA"点状征"阳性病例,适宜行开颅手术治疗,能够降低再出血率及死亡率。对于CTA"点状征"阴性病例,适宜行钻孔引流术治疗,操作简单,创伤较小。两种手术方式对于存活患者的预后影响没有差异。术前对病人进行合理的分类是必要的,CTA"点状征"为我们提供了一种良好的分类依据。
[Abstract]:Objective according to the classification of intracerebral hemorrhage (ICH) by CTA "dot sign", to study the curative effect of craniotomy and borehole drainage in treating hypertensive basal ganglia intracerebral hemorrhage with moderate dose of 30 ml ~ 60 ml), and to explore the choice of surgical methods. Methods 166 patients with moderate hypertensive basal ganglia hemorrhage were divided into two groups according to the existence of CTA "dot sign". Each type of intracerebral hemorrhage was randomly divided into two groups. The rate of rebleeding, mortality, modified Rankin score (mRSs) and activity of daily living (ADL) were compared between positive and negative patients with CTA "dot sign" after different surgical treatment. The two operative methods were evaluated. To explore the choice of surgical methods for moderate intracerebral hemorrhage. Results there was no significant difference in the rate of rebleeding, mortality rate and life dependence ratio (mRS2) and the ratio of Barthel index (鈮，

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