| 李锋,贾丕丰,张卫峰,等.血肿腔穿刺引流结合去骨瓣减压治疗基底节区脑出血 7例[J].安徽医药,2022,26(7):1352-1354. |
| 血肿腔穿刺引流结合去骨瓣减压治疗基底节区脑出血 7例 |
| Puncture and drainage of hematoma cavity combined with bone flap decompression in the treatment of 7 cases of basal ganglia intracerebral hemorrhage |
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| DOI：10.3969/j.issn.1009-6469.2022.07.018 |
| 中文关键词: 脑血管基底神经节出血 颅内出血，高血压性 减压颅骨切除术 穿刺抽液术 |
| 英文关键词: Basal ganglia hemorrhage Intracranial hemorrhage,hypertensive Decompressive craniectomy Paracentesis |
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| 中文摘要: |
| 目的评价血肿腔穿刺引流结合去骨瓣减压对基底节区脑出血手术疗效及安全性。方法回顾性研究 2017年 7—12月在云南迪庆藏族自治州人民医院，对 7例高血压基底节区大量脑出血重症病人施行血肿腔穿刺引流结合去骨瓣减压手术，术后评估病人 CT影像脑中线移位改善程度，意识水平格拉斯哥昏迷指数( GCS)恢复程度，术后病人生存质量，记录手术进行时间以及手术出血量，手术前后资料采用配对资料非参数检验。结果该 7例病人经过本手术后，术前 GCS评分为( 4.85±1.06)分，术后 1周后改善为( 10.85±1.21)分( P=0.017)；术前中线移位为( 11.28±1.79)mm术后次日恢复为( 4.85±1.06)mm(P= 0.014)；术后 3个月 GOS评分均大于 3分；手术进行时间小于 2h；手术出血量均小于 200 mL。结论对基底节区脑出血病人行血肿腔穿刺结合去骨瓣减压术可有效缓解脑组织移位，改善意识障碍，同时又可减少手术创伤缩短手术时间。 |
| 英文摘要: |
| Objective To valuate the efficacy and safety of hematoma puncture and drainage combined with decompression of boneflap for basal ganglia intracerebral hemorrhage. Methods The retrospective study was conducted in the People's Hospital of DiqingTibetan Autonomous Prefecture, Yunnan Province from July to December 2017, seven patients with severe intracerebral hemorrhage inthe basal ganglia region of hypertension were treated with hematoma puncture and drainage combined with decompressive surgery to re-move bone flap. The improvement degree of line shift in the brain of CT images, the recovery degree of consciousness level GCS, thepostoperative quality of life of the patients were evaluated. The average duration of surgery and the average amount of surgical bleedingwere recorded. The data before and after operation were analyzed by paired data nonparametric test. Result After the operation, themean preoperative GCS score of the 7 patients was (4.85±1.06), and it was improved to (10.85±1.21) one week after the operation(P=0.017). The median preoperative midline shift was (11.28±1.79) mm, and it was recover to (4.85±1.06) mm the next day after surgery(P=0.014). 3 months after surgery, the GOS scores were all greater than 3 points. Operation time was less than 2 hours. The operative bloodloss was less than 200 mL. Conclusions For patients with basal ganglia intracerebral hemorrhage, hematoma cavity puncture com-bined with bone flap decompression can effectively alleviate the brain tissue displacement, improve the disturbance of consciousness,and reduce the surgical trauma and shorten the operation time. |
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