CT定位下微创穿刺治疗高血压基底节区脑出血短期疗效分析.pdf

《CT定位下微创穿刺治疗高血压基底节区脑出血短期疗效分析.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、中华老年心脑血管病杂志2014年4月第16卷第4期ChinJGeriatrHeartBrainVesselDis，Apr2014，vo116，N0．4·391·临床研究．CT定位下微创穿刺治疗高血压基底节区脑出血短期疗效分析王立江，张吉荣，韩光良，胡术珍，于小青，成立峰，王久忠摘要：目的探讨CT定位下微创穿刺血肿清除术治疗老年高血压基底节区脑出血的短期临床疗效及影响因素。方法回顾性分析82例微创穿刺血肿清除术(微创组)患者和46例常规开颅血肿清除术(常规组)患者术前格拉斯哥昏迷评分(GCS)、血肿量、有无脑疝、有无急

2、性脑积水、手术时机和术后1个月GCS和生存情况。比较2组患者病死率和术后1个月GCS及影响微创组患者短期疗效的影响因素。结果微创组与常规组短期病死率比较，差异无统计学意义(26．8s15．2，P一0．132)。微创组术后GCS改善程度明显高于常规组(P一0．002)。手术时机和术前GCS是影响微创穿刺血肿清除术短期疗效的主要因素(OlR一4．140，95C1：1．153～14．862，P一0．029；OR一5．199，95CI：1．109～24．386，P一0．037)。结论CT定位下微创穿刺血肿清除术治疗老年高血压

3、基底节区脑出血短期疗效确切，早期行微创穿刺血肿清除术可显著改善患者短期预后。关键词：脑出血；血肿；穿刺术；高血压Short·-termcurativeeffectofCT--guidedminimallyinvasivepunctureonhemorrhageinbasalgangliaofelderlyhypertensivepatientswANGLi—jiang，ZHANGJi—rong，HANGuang—liang，etal(DepartmentofNeurosurgery，CentralHospitalof

4、ShengliOilfield，Dongying257034，ShandongProvince，China)Abstract：ObjectiveTostudytheshort—termcurativeeffectofCT—guidedminimallyinvasivepunctureonhemorrhageinbasalgangliaofelderlyhypertensivepatientsanditsinfluencingfac—tors．MethodsEighty～twoelderlyhypertensivepa

5、tientswhounderwentCT—guidedminimallyin—vasivepunctureforevacuationofhematomaservedasaminimallyinvasiveoperationgroupand46elderlyhypertensivepatientswhounderwentroutinecraniotomyforevacuationofhematomaservedasaroutineoperationgroupinthisstudy．Theirclinicaldatawe

6、reretrospectivelyana-lyzed，includinggender，age，Glasgowcomascale(GCS)score，hematomavolume，cerebralhernia，acutehydrocephalus，operationtime，postoperative1monthGCSscore，andsurvivaltime．Themortality，postoperative1monthGCSscore，andfactorsinfluencingtheshort～termcurat

7、iveeffectwerecompared．ResultsNosignificantdifferencewasfoundinmortalitybetweenthetwogroups(26．8．us15．2，P=0．132)．Thepostoperative1monthGCSscorewassignificantlyhigherinminimallyinvasiveoperationgroupthaninroutineoperationgroup(P一0．002)．Operationtimeandpreoperativ

8、eGCSscorewerethemajorfactorsinfluencingtheshort—termcurativeeffectofCT——guidedminimallyinvasivepunctureforevacuationofhematomainelderlyhypertensivepa—tients(OR一4．140，95CI：1．