[1]张　淇,李　辉,方开萱.个体化手术治疗对不同部位高血压性脑出血近期预后的影响[J].中国临床神经外科杂志,2016,(12):762-763.[doi:10.13798/j.issn.1009-153X.2016.12.010]
　ZHANG Qi,LI Hui,FANG Kai-xuan.Effects of individualized surgical plan on recent prognoses in patients with hypertensive intracerebral hemorrhage[J].,2016,(12):762-763.[doi:10.13798/j.issn.1009-153X.2016.12.010]
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个体化手术治疗对不同部位高血压性脑出血近期预后的影 响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年12期
页码:
762-763
栏目:
论著
出版日期:
2016-12-25

文章信息/Info

Title:
Effects of individualized surgical plan on recent prognoses in patients with hypertensive intracerebral hemorrhage
文章编号:
1009-153X（2016）12-0762-02
作者:
张　淇; 李　辉; 方开萱
734000 甘肃张掖，河西学院附属张掖人民医院神经外科（张　淇,李　辉,方开萱）
Author(s):
ZHANG Qi;  LI Hui;  FANG Kai-xuan
Department of Neurosurgery, Zhangye people’s Hospital Affiliated to Hexi College, Zhangye 734599, China
关键词:
高血压性脑出血; 手术; 个体化; 近期预后
Keywords:
individualized surgical plan;  hypertensive intracerebral hemorrhage;  recent prognosis
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2016.12.010
文献标志码:
A
摘要:
目的 探讨个体化手术治疗对不同部位高血压性脑出血近期预后的影响。方法 回顾性分析2010年2月至2016年3月手术治疗的712例高血压性脑出血的临床资料，根据治疗方法分为小骨窗组（320例，采用小骨窗开颅血肿清除术治疗）,大骨瓣组（232例，采用骨瓣开颅清除血肿术治疗）及外引流术组（160例，采用侧脑室外引流术治疗）。术后1个月采用GOS评分评估近期预后。结果 术后1 d，小骨窗组,大骨瓣组,外引流术组血肿清除率分别为（82.69±1.69）%,（90.55±1.65）%,（77.25±1.58）%；术后1个月，分别为（90.18±1.85）%,（90.34±1.65）%,（90.25±1.71）%。术后1个月，小骨窗组,大骨瓣组,外引流术组GOS评分分别为（4.01±0.69）分,（3.98±0.75）分,（4.12±0.71）分。结论 个体化手术治疗对不同部位高血压性脑出血近期预后存在一定影响，选择合理的手术治疗方案可改善患者预后。
Abstract:
Objective To investigate the effects of individualized surgical plan on the recent prognoses in patients with hypertensive intracerebral hemorrhage (HICH) in different cerebral regions. Methods The clinical data of 712 patients with HICH, who were divided into 3 groups, i.e. small bone window group, in which 320 patients underwent the evacuation of intracranial hematomas via small bone window, large bone window group, in which 232 patients underwent the evacuation of intracranial hematomas via large bone window and external drainage group, in which 160 patients underwent external ventricular drainage from the hematomas, in our hospital from February, 2010 to March, 2016, were retrospectively analyzed. All the patients were followed up for 1 month. The hematoma evacuation rates, occurrent rates of postoperative complication and prognoses were compared among those three groups. Results The occurrent rate of postoperative complications was significantly higher in the large bone window group than that in the small bone window group (P<0.05), which was significantly higher than that in the external drainage group (P<0.05). The rates of hematomas evacuation in the small bone window group, big bone window group and external drainage group were (90.18±1.85)%, (90.34±1.65)% and (90.25±1.71)% respectively. There was insignificant difference in the hematomas evacuation rate and GOS scores among those three groups 1 month after the operation (P>0.05). Conclusions The recent curative effects of individualized surgical plan on HICH in the different cerebral regions are good, but there is higher rate of postoperative complication occurrence in the patients with HICH undergoing the large bone window craniotomy.

参考文献/References:

[1] Biffi A, Anderson CD, Battey TW, et al. Association be- tween blood pressure control and risk of recurrent intra- cerebral hemorrhage [J]. JAMA, 2015, 314(9): 904-912.
[2] 赵　辉，寇红伟，刘宏建，等. 后路显微镜下硬脊膜切开治 疗高位腰椎间盘突出症疗效分析[J]. 中华显微外科杂 志，2015，38（4）：393-394.
[3] Wang X, Arima H, Heeley E, et al. Magnitude of blood pressure reduction and clinical outcomes in acute intra- cerebral hemorrhage: intensive blood pressure reduction in acute cerebral hemorrhage trial study [J]. Hypertension, 2015, 65(5): 1026-1032.
[4] Zheng J, Lin S, Li H, et al. Perioperative antihypertensive treatment in patients of spontaneous intracerebral hemo- rrhage (PATICH): a clinical trial protocol [J]. Contemp Clin Trials, 2014, 39(1): 9-13.
[5] 王立童，姜永梅，徐　红，等. 康复训练对高血压性脑出血 早期微创血肿清除术后肢体功能恢复的影响[J]. 中华物 理医学与康复杂志，2013，35（5）：378-381.
[6] 路　楷，徐彬彬，查海峰，等. 高血压脑出血外科治疗与预 后的相关性分析[J]. 中华神经外科疾病研究杂志，2014， 13（4）：354-356.
[7] 张福征，王才永，张　磊，等.神经内镜与开颅手术治疗高 血压脑出血的疗效比较[J]. 中华神经外科杂志，2015，31 （1）：19-21.
[8] 熊左隽，李　俊，梁　健，等.小骨窗开颅术治疗高血压脑 出血术后感染相关因素分析[J]. 中华医院感染学杂志， 2013，23（5）：1066-1067.
[9] Alhilali LM, Reynolds AR, Fakhran S. A multi-disciplinary model of risk factors for fatal outcome in posterior rever- sible encephalopathy syndrome [J]. J Neurol Sci, 2014, 347(1): 59-65.
[10] 常鹏飞，邬　巍，左　程，等. 单双管微创穿刺引流术治疗 大量基底节区高血压脑出血的疗效比较[J]. 中华实验外 科杂志，2015，30（9）：2258-2260.

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备注/Memo

备注/Memo:
作者单位：734000 甘肃张掖，河西学院附属张掖人民医院神经外科（张　淇,李　辉,方开萱） 通讯作者：李　辉，E-mail：lihui7714@163.com
更新日期/Last Update: 1900-01-01