【作者】 王孟阳； 段发亮； 吴京雷； 丁伟； 徐兴华； 陈晓雷； 罗明；

【Author】 Wang Mengyang;Duan Faliang;Luo Ming;

【机构】 武汉市第一医院(华中科技大学附属武汉市中西医结合医院)；

【摘要】 目的比较两种微创手术方法治疗高血压基底节出血的疗效。方法对80例高血压基底节出血患者进行随机对照研究,40例采用内镜血肿清除术,40例采用钻孔引流术、术后辅助尿激酶纤溶治疗并引流,手术均使用神经导航进行定位指导,比较其疗效。结果按血肿量40mL为限分为两个亚组,血肿量小于40mL为Ⅰ组,血肿量大于40mL为Ⅱ组,两组疗效无显著性差异(P>0.05),术后第1d、第3d、第7d,Ⅰ、Ⅱ亚组对照组血肿清除率分别为(52.18±15.74vs40.55±15.35%、70.95±13.33vs58.57±14.49%、74.50±19.05vs71.48±5.11%),大血肿Ⅱ组内镜血肿清除术疗效优于钻孔引流术(P<0.05)。结论两种微创手术方式均能有效清除血肿,针对较大血肿,应优先考虑内镜血肿清除术。更多还原

【Abstract】 Objective To compare the effect of two minimally invasive methods on the treatment of hypertensive basal ganglia hemorrhage.Methods A randomized controlled study of 80 patients with hypertensive basal ganglia hemorrhage was carried out.40 patients were treated with endoscopic hematoma evacuation,40 patients were operated by burr hole drilling and drainage with aid of urokinase injection,and the operation was guided by the neuronavigation and the effect was compared.All patients were divided into two subgroups according to the volume of hematoma,I subgroup with volume above 40 mL and II subgroup with volume below 40 mL Results The results showed that there was no significant difference between the two groups(P>0.05),while the clearance rate of endoscopic hematoma with hematoma volume of more than 40 milliliters was better than that of the burr hole drilling.The clearance rate of two subgroups Id after surgery was(52.18±15.74 vs40.55±15.35%,3 d 70.95±13.33 vs58.57±14.49% and 7 d 74.50±19.05 vs71.48 ± 5.11%).(P <0.05).Conclusion Two minimally invasive surgical methods can effectively evacuate hematoma.For patients with large hematoma,endoscopic hematoma removal should be given priority.更多还原