[1]王凯杰 范光伟 蔡新旺 刘欢 刘宽 崔建忠**.术前血肿形态对高血压脑出血微创手术后血肿清除率的影响[J].中国微创外科杂志,2020,01(9):789-792.
　Wang Kaijie,Fan Guangwei,Cai Xinwang,et al.Effects of Hematoma Morphology on Hematoma Clearance Rate After Minimally Invasive Surgery for Hypertensive Intracerebral Hemorrhage[J].Chinese Journal of Minimally Invasive Surgery,2020,01(9):789-792.
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术前血肿形态对高血压脑出血微创手术后血肿清除率的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年9期
页码:
789-792
栏目:
临床研究
出版日期:
2020-09-25

文章信息/Info

Title:
Effects of Hematoma Morphology on Hematoma Clearance Rate After Minimally Invasive Surgery for Hypertensive Intracerebral Hemorrhage
作者:
王凯杰 范光伟 蔡新旺 刘欢 刘宽 崔建忠**
（河北省唐山市工人医院神经外二科，唐山063000）
Author(s):
Wang Kaijie;  Fan Guangwei;  Cai Xinwang;  et al.
Department of Neurosurgery, Tangshan Gongren Hospital, Tangshan 063000, China
关键词:
高血压脑出血; 微创手术; 血肿形态; 血肿清除率
Keywords:
Hypertensive intracerebral hemorrhage (HICH); Minimally invasive surgery (MIS); Hematoma morphology; Hematoma clearance rate
文献标志码:
A
摘要:
目的探讨高血压脑出血手术前血肿形态对微创置管引流术血肿清除率的影响。方法2018年1月～2019年12月我科应用爱福迪恩颅脑手术头架引导进行微创血肿穿刺引流术治疗高血压脑出血90例，按照血肿形态分为规则组（53例）和不规则组（37 例）。比较2组术后即刻和术后1、3 d血肿残余量和血肿清除率、术后2周再出血率、术后3个月MRS评分。结果规则组术后即刻和术后1、3 d血肿残余量明显少于不规则组（Z=-4.576，P=0.000；Z=-5.851，P=0.000；Z=-6.828，P=0.000）。规则组术后即刻、术后1、3 d血肿清除率明显高于不规则组（Z=-5.974，P=0.000；t=8317，P=0.000；Z=-7.425，P=0.000）。术后2周内再出血率规则组低于不规则组，但差异无显著性（1.9% vs.10.8%, χ2=1.825,P=0177）。术后3个月改良Rankin量表(Modified Rankin Scale，MRS)评分评估预后，规则组预后不良发生率明显低于不规则组（Z=-2.127，P=0.033）。结论术前血肿形态规则，微创术后血肿残余少，清除率高，预后良好,术前血肿形态规则者可能更加适合微创穿刺引流手术。
Abstract:
ObjectiveTo explore the relationship between hematoma morphology of hypertensive intracerebral hemorrhage (HICH) and hematoma clearance rate by minimally invasive surgery (MIS).MethodsA total of 90 HICH patients who underwent MIS with the operation frame were divided into either regular group (53 cases) or irregular group (37 cases) according to hematoma morphology. The residual amount and clearance rate of hematoma were compared immediately after operation, 1 day after operation and 3 days after operation. Rebleeding rate was compared at 2 weeks, and the Modified Rankin Scale(MRS) was compared at 3 months.ResultsThe residual amount of hematoma immediately after operation, 1 day after operation and 3 days after operation were lower in the regular group than those in the irregular group with significantly difference (Z=-4.576, P=0.000; Z=-5.851, P=0.000; Z=-6.828, P=0.000). The hematoma clearance rate of the regular group was significantly higher than that of irregular group immediately after operation, 1 day after operation and 3 days after operation (Z=-5.974, P=0.000; t=8.317, P=0.000; Z=-7.425, P=0.000). The rebleeding rate at 2 weeks of the regular group was lower than that of the irregular group (1.9% vs. 108%, χ2=1.825, P=0.177). The prognosis was evaluated by the MRS score at 3 months after surgery. The incidence of poor prognosis in the regular group was lower than that in the irregular group, and the difference was statistically significant (Z=-2.127, P=0.033).ConclusionThe patients with regular preoperative hematoma morphology have less residual hematoma, high clearance rate and good prognosis after minimally invasive surgery, and may be more suitable for minimally invasive puncture and drainage.

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备注/Memo

备注/Memo:
基金项目：河北省2017年度医学科学研究重点课题（20171355）**通讯作者：Email：lwapple168@sina.cn
更新日期/Last Update: 2020-12-09