微创穿刺辅助开颅减压治疗高血压脑出血突发脑疝的效果

发布时间：2018-11-15 08:55

【摘要】：目的探讨微创穿刺辅助开颅减压抢救高血压脑出血致脑疝患者的意义。方法 92例高血压病脑出血患者纳入研究,所有患者治疗方案随机分为3组,血肿微创穿刺引流组采取颅内血肿微创穿刺辅助开颅血肿清除手术,脑室微创穿刺组采取脑室微创穿刺辅助开颅血肿清除手术,传统甘露醇组采取甘露醇辅助传统开颅血肿清除手术。分析3组患者预后及操作相关指标。结果脑室微创穿刺组瞳孔回复时间及脑疝持续时间最短并获得最少的病死率(P0.01),在操作耗时及非死亡率方面,血肿微创穿刺引流组与脑室微创穿刺组等同;血肿微创穿刺引流组瞳孔回复时间、脑疝持续时间及病死率均优于传统甘露醇组(P0.05)。结论微创穿刺血肿引流与脑室微创穿刺等微创操作较传统甘露醇辅助开颅血肿清除术能更快解除脑疝压迫,从而改善患者预后。
[Abstract]:Objective to explore the significance of minimally invasive puncture assisted craniotomy in the treatment of cerebral hernia caused by hypertensive intracerebral hemorrhage. Methods 92 patients with hypertensive intracerebral hemorrhage were included in the study. All the patients were randomly divided into 3 groups. The patients in the hematoma minimally invasive puncture drainage group were treated with intracranial hematoma minimally invasive puncture assisted craniotomy and hematoma clearance. The ventricular minimally invasive puncture group was used to assist the craniotomy hematoma removal, and the traditional mannitol group was used to assist the traditional craniotomy hematoma removal operation. The prognosis and operation related indexes were analyzed in 3 groups. Results the recovery time of pupil and the duration of cerebral hernia were the shortest and the least mortality was obtained in the group of minimally invasive puncture of cerebral ventricle (P0.01). In terms of operation time and non-mortality, the group of hematoma minimally invasive puncture and drainage was the same as the group of minimally invasive puncture of cerebral ventricle. The recovery time of pupil, the duration of cerebral hernia and the mortality of hematoma minimally invasive puncture drainage group were better than those of traditional mannitol group (P0.05). Conclusion minimally invasive procedures such as minimally invasive hematoma drainage and minimally invasive intracerebroventricular puncture are more effective than traditional mannitol assisted craniotomy to relieve the compression of cerebral hernia and improve the prognosis of the patients.
【作者单位】：深圳市宝安区人民医院神经外科;
【分类号】：R651.12

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