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马少彬1 韩焕超1▲ 吴 晖1 何燕红2 陈德生1 黄志刚1 梁艺湖1 刘成金3.微创双软通道引流术与尿激酶联用治疗大容积高血压脑出血的临床效果[J].中国现代医生,2021,59(27):21-24
微创双软通道引流术与尿激酶联用治疗大容积高血压脑出血的临床效果
Clinical effect of minimally invasive double soft channel drainage combined with urokinase in the treatment of massive hypertensive intracerebral hemorrhage
  
DOI:
中文关键词:  高血压脑出血  锁孔开颅血肿清除术  双软通道引流术  尿激酶
英文关键词:Hypertensive cerebral hemorrhage  Keyhole craniotomy hematoma removal  Double soft channel drainage  Urokinase
基金项目:广东省佛山市自筹经费类科技计划项目(2017 AB000882)
作者单位
马少彬1 韩焕超1▲ 吴 晖1 何燕红2 陈德生1 黄志刚1 梁艺湖1 刘成金3 1.广东省佛山市南海区第四人民医院神经外科广东佛山 5282222.广东省佛山市南海区第四人民医院心血管内科广东佛山 5282223.广东省佛山市南海区第四人民医院放射科广东佛山 528222 
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中文摘要:
      目的 探讨微创双软通道引流术治疗大容积高血压脑出血患者的疗效。方法 选取2018 年1 月至2019 年9 月我院收治的79例出血量超过60 mL的高血压脑出血患者为研究对象,采用随机数字表法分为试验组(n=40)和对照组(n=39),其中试验组采用微创双软通道引流术治疗,对照组采用锁孔开颅血肿清除术治疗。对两组患者首次血肿清除率、血肿消除时间、手术时间、住院时间、术后并发症、两组术前及术后格拉斯哥意识障碍评分、6 个月后格拉斯哥预后量表评分等数据进行分析。结果 试验组的首次血肿清除率为32.50%,低于对照组的79.49%,差异有统计学意义(P<0.05)。两组患者的血肿消除时间比较,差异无统计学意义(P>0.05);试验组患者的手术时间为(1.10±0.25)h、住院时间为(22.1±2.12)d,均短于对照组的(3.27±0.42)h、(31.1±4.42)d,差异有统计学意义(P<0.05)。试验组患者术后并发症总发生率为45.00%,低于对照组的58.97%,差异有统计学意义(P<0.05)。两组术后1 周GCS 评分均较术前明显升高,与各组术前比较,差异均有统计学意义(P<0.05)。两组术后1 周GCS评分比较,差异无统计学意义(P>0.05)。病死率、术后6 个月格拉斯哥预后量表评分良好率比较,差异无统计学意义(P>0.05)。结论 应用微创双软通道引流术联合尿激酶治疗出血量超过60 mL的高血压脑出血患者,能较快清除血肿,手术创伤小,并发症少,值得在基层医院推广。
英文摘要:
      Objective To investigate the therapeutic efficacy of minimally invasive double soft channel drainage on patients with hypertensive cerebral hemorrhage.Methods A total of 79 patients with hypertensive cerebral hemorrhage with hemorrhage exceeding 60 mL admitted to our hospital from January 2018 to September 2019 were selected as the research objects,which were divided into the experimental group (n=40) and the control group (n=39) according to the random number table method.The experimental group was treated with minimally invasive double soft channel drainage,while the control group was treated with keyhole craniotomy and hematoma removal.The first hematoma clearance rate,hematoma elimination time,operation time,hospitalization time,postoperative complications,Glasgow coma scale (GCS) scores before and after operation of the two groups,Glasgow outcome scale (GOS) scores after 6 months,average hospitalization days and other data were statistically compared and analyzed.Results The first hematoma clearance rate of the experimental group was 32.50%,lower than 79.49% of the control group,with statistically significant difference after examined(P<0.05).There was no statistically significant difference in hematoma elimination time between the two groups of patients(P>0.05).The operation time(1.10±0.25)hours and the hospitalization time (22.1±2.12) days of the experimental group were shorter than (3.27±0.42)hours and (31.1±4.42)days of the control group,with statistically significant differences (P<0.05).The total incidence of postoperative complications in patients of the experimental group was 45.00%,lower than 58.97% of the control group,with statistically significant difference (P<0.05).After 1 week of operation,GCS scores of the two groups were significantly higher than those before operation,all with statistically significant difference (P<0.05).After 1 week of operation,there was no statistically significant difference in GCS scores between the two groups (P>0.05).There were no significant differences in mortality rate and good rate of GOS score 6 months after operation (P>0.05).Conclusion The application of minimally invasive double soft channel drainage combined with urokinase was used to treat patients with hypertensive cerebral hemorrhage volume more than 60 mL.Meanwhile,it can quickly clear the hematoma,with less surgical trauma and fewer complications,which is worthy of promotion in grass-roots hospitals.
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