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时间:2020-04-22
《立体定向手术与内科治疗中小量基底核区高血压性脑出血的对比研究-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·442·中国微创外科杂志2014年5月1鲞箍翅!理型!:!:!:!:临床论著·立体定向手术与内科治疗中小量基底核区高血压性脑出血的对比研究杨川勾俊龙毛群”刘宗惠①(天津市第三医院神经外科,天津300250)【摘要】目的研究中小量(15~40m1)基底核区高血压性脑出血应用立体定向治疗与内科保守治疗对患者病死率、运动功能及预后的影响。方法2003年1月~2013年1月,我院收治中小量基底核区高血压性脑出血164例,其中82例行立体定向手术抽吸结合尿激酶引流治疗,另82例行内科保守治疗。比较2组血肿清除时间、30d病死率、患侧肢体运动功能和90d格拉斯哥
2、预后评分(Glasgowoutcomescore,GOS)。结果立体定向治疗组血肿消散时间(3.8±1.1)d,明显短于内科治疗组的(19.9±3.5)d(t=一39.463,P=0.000)。2组30d病死率差异无显著性。立体定向组治疗30d病肢肌力4~5级[43.9%(36/82)vs.28.0%(23/82),=4.474,P=0.034]和90dGOS5分者的比例明显高于内科治疗组[53.7%(44/82)vs.36.6%(30/82),=4.826,P=0.028]。结论对于中小量高血压性脑出血,行立体定向手术治疗比内科治疗能明显加快血肿清除
3、时间,改善患者的功能预后。【关键词】高血压性脑出血;基底核区;立体定向技术中图分类号:R651.1;R743.34文献标识:A文章编号:1009—6604(2O14)05—0442—03doi:10.3969/j.issn.1009—6604.2014.05.018:AComparativeStudyofStereotacticSurgeryandCOnservativeTreatmentforSmal1.andModerate-volumeHypertensiveCerebralHemorrhageinBasalGangliaArearangChua
4、n,GouJunlong,MaoQun,eta1.DepartmentofNeurosurgery,TheThirdHospitalofTianjin,Tiain300250,China【Abstract】0bjectiveToevaluatethemortalityrate,motorfunctionandprognosisofsmall—andmoderate—volumehypertensivecerebralhemorrhageinbasalgangliaareatreatedbystereotacticsurgeryorconservativ
5、etreatment.MethodsFromJanuary2003toJanuary2013,164casesofsmall—andmoderate—volumehypertensivecerebralhemorrhageinbasalgangliaareaweretreatedinourhospita1.Ofthe164patients,82weretreatedwithstereotacticsurgerycombinedwithinstillationofurokinase,and82receivedconservativetreatment.T
6、hehematomaclearancetime.themortalityrateandmotorfunctionoftheparalyticlimbsatday30andtheGlasgowoutcomescore(GOS)atday90afterthetreatmentwerecomparedbetweenthetwogroups.ResultsInstereotacticgroup,thedissipationtimeofhematoma(3.8±1.1d)wassignificantlyshorterthanthatinconservativeg
7、roup(19.94-3.5d.t=一39.463,P=0.000).Themortalityrateatday30afterthetreatmentwasnotsignificantlydifferentbetweenthetwogroups.Instereotacticgroup,therateofpatients’diseasedlimbwithmusclestrengthlevel4—5atday30andGOSscoresof5pointsatday90afterthetreatmentweresignificantlyhigherthant
8、hoseinconservativegroup[43.9%(36/82)vs.28.0%(23
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