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两种不同手术方式治疗对高血压基底节区脑出血患者围术期指标ADL评分及术后并发症的影响 预览 被引量:3

Effects of two Different Surgical Methods on Perioperative Indexes ADL Score and Postoperative Complications in Patients with Hypertensive Intracerebral Hemorrhage in Basal Ganglia
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摘要 目的:分析两种不同手术方式治疗对高血压基底节区脑出血(HICH)患者围术期指标、日常生活能力(ADL)评分及术后并发症的影响。方法:选取2015年1月至2018年1月我院收治的基底节区HICH患者86例为研究对象,依据手术方式不同将其分为观察组、对照组分别40例、46例,观察组在神经内镜下行微创手术,对照接受小骨窗开颅显微术,记录两组手术围术期指标、手术后7d内颅内压变化,采用ADL量表、格拉斯哥预后量表(GOS)评估其术后6个月内日常生活能力、预后情况,并记录并发症。结果:观察组手术时间、术中失血量、住院时间短/低于对照组,观察组血肿清除率高于对照组(P<0.05);术后3d、7d观察组颅内压明显低于对照组(P<0.05);术后3个月、6个月观察组ADL评分较对照组高,差异有统计学意义(P<0.05);观察组术后6个月GOS分级优于对照组(P <0.05);术后6个月内观察组并发症发生率5.00%低于对照组19.57%(P<0.05)。结论:与小骨窗开颅显微术相比,采用神经内镜微创手术治疗基底节区HICH可明显改善患者围术期指标,有效清除血肿、降低颅内压,提高术后日常生活能力及预后水平,且并发症少,值得在临床推广实践。 Objective: To analyze the effects of two different surgical methods on perioperative indexes,activities of daily living (ADL) score and postoperative complications in patients with hypertensive intracerebral hemorrhage (HICH) in basal ganglia. Methods: 86 patients with HICH in basal ganglia who were admitted to the hospital during the period from January 2015 to January 2018 were selected as subjects. According to different surgical methods,they were divided into the observation group (40 cases) and the control group (46 cases). The observation group was treated by neuroendoscopic minimally invasive surgery,and the control group was treated by small bone window craniotomy microsurgery. The perioperative indexes and changes of intracranial pressure within 7 days after surgery were recorded. The ADL scale and the Glasgow Outcome Scale (GOS) were used to evaluate the activities of daily living and prognosis within 6 months after surgery,and complications were recorded. Results: The surgical time,intraoperative blood loss and hospital stay of the observation group were shorter/less than those of the control group,and the hematoma clearance rate was higher than that in the control group (P <0.05). The intracranial pressure of the observation group was significantly lower than that of the control group at 3 days and 7 days after surgery (P <0.05). The ADL scores of the observation group were higher than those of the control group at 3 months and 6 months after surgery (P < 0.05).The GOS grade of the observation group was better than the control group at 6 months after surgery (P <0.05),and the incidence of complications in the observation group within 6 months after surgery was lower than that in the control group (5.00% vs 19.57%) (P <0.05). Conclusion: Compared with small bone window craniotomy microsurgery,neuroendoscopic minimally invasive surgery for HICH in basal ganglia can significantly improve the perioperative indexes,effectively remove hematoma,reduce intracranial pressure,improve postoperative activities of
作者 郑玺 孙敦鑫 殷捷 ZHENG Xi;SUN Dunxin;YIN Jie(The 474 Hospital of PLA,Xinjiang Urumqi 830013,China)
出处 《河北医学》 CAS 2019年第3期618-623,共6页 Hebei Medicine
基金 新疆维吾尔自治区自然科学基金,(编号:2015201C3946).
关键词 手术方式 高血压基底节区脑出血 围术期 ADL评分 Surgical method Hypertensive intracerebral hemorrhage in basal ganglia Perioperative period ADL score
作者简介 通讯作者:殷捷。
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