【摘要】 目的探讨颅内压(ICP)监测辅助下行控制性减压用于长期口服抗血小板药物高血压性脑出血(HCH)患者疗效及安全性。方法回顾性分析我院2016年6月-2018年6月收治长期口服抗血小板药物HCH患者共124例临床资料,其中68例采用常规微创引流术治疗设为对照组,56例采用微创引流术中行ICP辅助下控制性减压设为观察组,比较两组术中血肿清除率率、血肿腔内引流管留置时间、术后并发症发生率及术后6个月GOS评分分级情况。结果观察组术中血肿清除率低于对照组(P<0.05);观察组血肿腔内引流管留置时间多于对照组(P<0.05);观察组术后再出血、头皮渗液及颅内感染发生率均低于对照组(P<0.05);观察组术后6个月GOS分级预后良好率高于对照组(P<0.05)。结论 ICP辅助下行控制性减压用于长期口服抗血小板药物HCH患者治疗可有效降低术后并发症发生风险,提高手术安全性,并有助于改善远期预后;但该术式较常规微创引流术可能导致术中血肿清除率下降和置管时间延长。更多还原

【Abstract】 Objective To investigate the application effects of controlled decompression assisted by ICP monitoring in the treatment of HCH patients with antiplatelet drug for long-term oral antiplatelet drug.Methods Clinical data of 124 HCH patients with antiplatelet drug for long-term oral antiplatelet drug from June 2016 to June 2018 in our hospital were chosen and divided into 2 groups including control group(68 patients) with routine minimally invasive drainage and observation group(56 patients) with controlled decompression assisted by ICP monitoring on the basis of minimally invasive drainage; and the removal rate of hematoma, indwelling time of drainage tube in hematoma cavity, complications incidence after operation and GOS grading in 6 months after operation were compared between the two groups.Results The removal rate of hematoma of observation group were significantly lower than control group(P<0.05).The indwelling time of drainage tube in hematoma cavity of observation group were significantly longer than control group(P<0.05).The complications incidence after operation of observation group were significantly lower than control group(P<0.05).The GOS grading in 6 months after operation of observation group were significantly better than control group(P<0.05).Conclusion Controlled decompression assisted by ICP monitoring in the treatment of HCH patients with long-term oral antiplatelet drug can efficiently reduce the postoperative complications risk, higher the surgery safety and be helpful to improve the long-term prognosis; but compared with routine minimally invasive drainage, it may lead to decreased hematoma clearance rate and prolongation of catheterization time.更多还原