基層醫(yī)院高血壓腦出血63例微創(chuàng)治療體會(huì)

[摘要]目的 探討基層醫(yī)院治療高血壓腦出血的方法和效果。 方法 醫(yī)院急診收治并采用微創(chuàng)顱內(nèi)血腫清除術(shù)治療的高血壓腦出血患者63例，作為觀察組，同時(shí)回顧2007年以前采用開(kāi)顱手術(shù)治療的63例患者的臨床資料作為對(duì)照組。 結(jié)果 觀察組患者的總有效率與對(duì)照組患者相比，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。觀察組患者的神經(jīng)功能缺損程度的改善情況明顯優(yōu)于對(duì)照組（P<0.05）。 結(jié)論 微創(chuàng)顱內(nèi)血腫清除術(shù)治療高血壓腦出血與開(kāi)顱手術(shù)具有同樣的良好治療效果，同時(shí)具有操作簡(jiǎn)單、創(chuàng)作小、恢復(fù)快等特點(diǎn)，適合在基層醫(yī)院使用。

[關(guān)鍵詞] 高血壓腦出血；基層醫(yī)院；微創(chuàng)

[中圖分類號(hào)] R651.12 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 2095-0616（2012）22-207-02

Minimally invasive treatment experience of 63 patients with hypertensive intracerebral hemorrhage in primary hospital

LIU Liying

Department of Neurosurgery，People's Hospital of Shulan City，Shulan 132600，China

[Abstract] Objective To study the treatment method and effect of hypertensive cerebral hemorrhage patients treated in primary hospitals. Methods 63 cases of patients with hypertensive cerebral hemorrhage who were treated with minimally invasive intracranial hematoma clear operation in emergency of our hospital were selected as observation group，and the data of 63 patients who were treated with craniotomy before 2007 were selected as control group. Results The total efficiency of observation group compared with control group，the difference was not statistically significant （P>0.05）. Neurologic function defect degree of observation group improved significantly better than the control group （P<0.05）. Conclusion The effect of minimally invasive and craniotomy treatment is equally good，and the minimally invasive treatment has some advantage such as simple operation，less creation and fast recovery，et. So it is suitable for application in primary hospitals

[Key words] Hypertensive intracerebral hemorrhage；Primary hospitals；Minimally invasive

近年來(lái)，隨著人們生活習(xí)慣的改變，高血壓的發(fā)病率越來(lái)越高，由高血壓導(dǎo)致的腦出血的發(fā)病率也越來(lái)越高。高血壓腦出血是目前臨床比較急重的疾病，具有很高的死亡率和致殘率。筆者采用微創(chuàng)顱內(nèi)血腫清除術(shù)治療高血壓腦出血患者63例，取得了滿意的效果，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

63例患者均為筆者所在醫(yī)院2007年3月～2011年3月急診收治并采用微創(chuàng)顱內(nèi)血腫清除術(shù)治療的高血壓腦出血患者，作為觀察組，所有患者均符合高血壓腦出血的診斷標(biāo)準(zhǔn)，并經(jīng)急診頭部CT檢查確診為腦出血，均為發(fā)病3 h內(nèi)入院，入院時(shí)患者的收縮壓在180 mmhg以上。其中男38例，女25例；年齡29～73歲，平均（59.55±11.86）歲；高血壓病史1～21年，平均（10.37±5.85）年；血腫體積：30～180 mL，平均（78.66±19.75）mL；CT提示顱內(nèi)出血部位：32例患者為基底節(jié)出血，5例患者出血破入腦室，24例患者為腦葉出血，2例患者為丘腦出血；……