微创颅内血肿清除术治疗高血压脑出血的疗效观察-脑出血颅内血肿区别.docx

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1、微创颅内血肿清除术治疗高血压脑出血的疗效观察:脑出血颅内血肿区别 摘要 目的 观察微创颅内血肿清除术治疗高血压脑出血（HICH）的临床效果，探讨最佳的临床术式。 方法 选择已确诊的HICH患者48例，并随机分为观察组和对照组，每组各24例，其中观察组采用微创颅内血肿清除术治疗，对照组采用内科保守治疗，观察并比较两组患者术后的临床效果。 结果 观察组的总有效率为79.2%，明显高于对照组的54.2%，两组比较差异有统计学意义（P 0.05）；观察组重残发生率为20.0%，明显低于对照组的30.8%，两组比较差异有统计学意义（P 0.05）。 结论 微创颅内血肿清除术能快速清除血肿，降低颅内压、病

2、死率及致残率，减轻脑水肿，近期疗效确切，促进患者意识恢复，是治疗HICH的最佳方法。关键词 高血压脑出血；微创颅内血肿清除术；临床疗效中图分类号 R651.11 文献标识码 A 文章编号 1673-7210（x）07（c）-0041-03The observation of the curative effect on minilogic evacuation of intracranial hematoma treatment for hypertensive intra cerebral hemorrhageYU Yuxing LUO Biao CHEN WeishiDepartment

3、of Neurosurgery Sursery, the Peoples Hospital of Taishan City, Guangdong Province, Taishan 529200, ChinaAbstract Objective To observe the clinical effect on the minilogic evacuation of intracranial hematoma treatment for hypertensive intra cerebral hemorrhage, to discuss the best modus operandi in t

4、he clinical. Methods 48 patients with hypertensive intra cerebral hemorrhage, who were diagnosed, were chosen and randomly divided into observation group and control group, each group had 24 cases, the observation group was treated by the minilogic evacuation of intracranial hematoma, and the contro

5、l group was treated by the expectant treatment, the curative effects of two groups after surgery were observed. Results The total effective rate of the observation group was 79.2%, which was higher than the control group for 54.2%, there was different statistical significance between two groups (P 0

6、.05). The incidence rate of giantmaimer in the observation group was 20.0%, which was lower than the control group for 30.8%, there was different statistical significance between two groups (P 0.05). Conclusion The minilogic evacuation of intracranial hematoma can clean up the haematoma, reduce the

7、intracranial pressure case fatality rate and crippling rate, and abate the hydrocephalus, reliable curative effect in the recent period, and can accelerate the patients consciousness, it is a best way to treat the HICH.Key words Hypertensive intra cerebral hemorrhage; Minilogic evacuation of intracr

8、anial hematoma; Curative effect高血压脑出血（hypertensive intra cerebral hemorrhage，HICH）是急性脑血管病中致残率及死亡率最高的一种自发性脑出血1，是高血压伴脑小动脉瘤、血压骤升使动脉破裂所致2。HICH患者在出血后24 h之内死亡的占42.1%70.6%，在1周内死亡的占72.8%92.5%3。目前国内外统计的外科治疗HICH患者的死亡率为3%51%，20%所占的比例较多，明显低于内科保守治疗死亡率的50%90%，说明外科手术治疗HICH的主要手段，但是到目前为止，仍然没有统一的标准，随着微创技术的不断发展和改善，微创手术的应用大大提高了手术治疗HICH的临床疗效，从而有效地降低了患者的病死率和致残率4。微创颅内血肿清除术是继脑出血内科保守治疗和外科开颅血肿消除术的一种新技术，由于该技术具有快速、安全、简便、创伤小等优点，现已受到越来越多临床医生和患者的青睐而得到广泛应用，其治疗急性脑血管病的疗效已被国内外所认可5。本文通过观察微创颅内血肿清除术治疗HICH的疗效及其优缺点，探索出更具优势的外科手术方法，为临床外科手术提供依据，现总结分析报道如下：