基底节脑出血微创手术和传统开颅术的疗效比较及影响因素分析

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1、维普资讯http://www.cqvip.com·282·中国危重病急救医学2006年旦箜鲞笙塑!堡：：：!：·论著·基底节脑出血微创手术和传统开颅术的疗效比较及影响因素分析潘剑威詹仁雅童鹰马跃辉【摘要】目的比较基底节脑出血微创(小骨窗)开颅手术与传统(骨瓣)开颅手术治疗的疗效，并分析造成差异的因素。方法符合出血性脑卒中规范化治疗人选标准的基底节脑出血患者55例，其中微创手术28例(微创组)，传统手术27例(骨瓣组)。观察术后并发症，术后3d及2周意识情况，以及术后3个月的日常生活能力(ADL)。以SPSS10．0进行统计分析。结果术后3d意识障碍者骨瓣组19例，微创组10例(P<0．01)

2、。骨瓣组出现肺部感染和(或)器官功能障碍17例，而微创组为11例(P<0．05)。术后3个月骨瓣组植物状态5例，死亡3例，占29．6；微创组分别为3例和2例，占17．8(P<0．05)。除去植物状态及死亡病例，两组ADL比较差异无显著性(P>0．05)。结论微创手术可使患者意识较早恢复，减少并发症，从而减少植物生存和死亡率，对晚期神经功能恢复无明显影响。【关键词】脑出血，基底节；微创手术；传统开颅术；疗效；影响因素Comparisonofcurativeeffectandanalysisofinfluencingfactorsinpatientswithbasalganglionhemorr

3、hagetreatedwithtraditionalcraniotomyandmini—invasiveoperationPANJian—wei，zHANRen—ya，ToNGYing，MAYue—hui．DepartmentofNeurosurgery，FirstAffiliatedHospitalofMedicalCollege，ZhejiangUniversity，Hangzhou310003，Zhejiang，China[Abstract]ObjectiveTocomparethecurativeeffectoftraditionalcraniotomyandmini—invasiv

4、eoperationonbasalganglionhemorrhage，andanalyzeinfluencingfactorsrelatedtothedifferences．MethodsFifty—fivecaseswithbasalganglionhemorrhageaccordingwiththeenrollmentcriterionofstandardizedtreatmentofhemorrhagicstrokewereanalyzed．Twenty-eightcasesweretreatedwithmini-invasiveoperation(mini-invasivegrou

5、p)and27caseswithtraditionalcraniotomy(craniotomicalgroup)．Theevaluationindexesincludedpostoperativecomplications，consciousnessin3daysand2weeksafteroperation，andactivityofdailylire(ADL)in3monthsafteroperation．SPSS10．0softwarewasusedforstatisticalanalysis．ResultsThreedaysafteroperation，19casesand10ca

6、sesofabnormalconsciousnesswereincraniotomicalgroupandmini-invasivegroup，respectively(P<0．O1)．Seventeencaseshadpulmonaryinfectionand／ororgandysfunctionincraniotomicalgroup，and11casesinmini-invasivegroup(P<0．05)．Threemonthsafteroperation。5caseswereinvegetablestatusand3diedincraniotomicalgroup，account

7、ingfor29．6，while3caseswereinvegetablestatusand2diedinmini-invasivegroup，accountingfor17．8(P<0．05)．NodifferenceinADLwasfoundinthetwogroupswithanexceptionofcasesofvegetablestatusanddeath(P>0．05)．ConclusionMin