【摘要】 目的探讨微创手术在高血压基底节脑出血患者中的应用价值。方法收集因高血压基底节区脑出血行手术治疗的90例患者临床资料,根据手术方式不同分为简易立体定向血肿引流术组(观察A组)45例、小骨窗开颅手术组(观察B组)30例和传统骨瓣开颅手术组(对照组) 15例,比较3组手术效果、患者神经功能改善情况、并发症及再出血率。结果观察A组、观察B组与对照组的临床有效率比较差异无统计学意义(P> 0.05)。术前3组神经功能缺损程度量表(NIHSS)评分比较差异无统计学意义(P> 0.05),术后7、14、28 d观察A组、B组NIHSS评分均低于对照组(P均<0.05)。3组患者并发症总发生率和再出血率比较差异均有统计学意义(P均<0.05),其中观察A组并发症总发生率低于观察B组、再出血发生率低于对照组(P均<0.017)。结论应用微创手术治疗高血压基底节区脑出血可以达到传统手术相似的临床效果、改善患者神经功能状况,并减少各类并发症和再出血的发生,相较于小骨窗开颅手术,简易立体定向血肿引流术安全性更高。更多还原

【Abstract】 Objective To evaluate the application value of minimally invasive surgery in the treatment of hypertensive cerebral hemorrhage in the basal ganglia. Methods Clinical data of 90 patients with hypertensive cerebral hemorrhage in the basal ganglia undergoing surgery were retrospectively analyzed. According to different surgical methods, all patients were divided into the control group(traditional bone flap craniotomy, n = 15), group A(stereotactic hematoma drainage, n = 45) and group B(small bone window craniotomy, n = 30). Surgical efficacy, improvement of nerve function, postoperative complications and rebleeding rate were statistically compared among three groups. Results The clinical efficacy of three surgeries did not significantly differ(P > 0.05). Preoperative NIHSS scores did not significantly differ among three groups(P > 0.05). At postoperative 7, 14 and 28 d, the NIHSS scores in the group A and group B were significantly lower than those in the control group(all P < 0.05). The total incidence of postoperative complications and rebleeding rate significantly differed among three groups(both P < 0.05). The incidence of postoperative complications in group A was significantly lower than that in group B, and the rebleeding rate was remarkably lower compared with that in the control group(both P < 0.017). Conclusions Compared with traditional surgery, minimally invasive surgery can achieve equivalent clinical efficacy, improve the nerve function and lower the risk of postoperative complications and rebleeding rate in patients with hypertensive cerebral hemorrhage in the basal ganglia. Compared with small bone window craniotomy, stereotactic hematoma drainage can yield higher safety.更多还原