锁孔手术治疗自发性和部分外伤性脑出血的临床观察
Clinical observation of keyhole surgery in the treatment of spontaneous and partial traumatic intracerebral hem-orrhage
郭志旺 1郭仰韩 1杜文欢 1张顺 1常会民 1林鹏 1许宝来 1方翠容1
作者信息
- 1. 中国人民武装警察部队广东总队医院神经外科(广东 广州 510507)
- 折叠
摘要
目的 探讨锁孔手术在自发性脑出血和部分外伤性脑出血患者中的应用.方法 回顾性分析武警广东总队医院神经外科经锁孔手术治疗的120例自发性脑出血患者(包括高血压脑出血96例、脑动脉瘤破裂出血15例、脑血管畸形破裂出血患者9例)和40例外伤性脑出血患者的临床资料,进行总结分析,均在发病72 h内手术.结果 术后2～24 h内复查CT,首次血肿清除率90％以上者126例(86.8％),15例动脉瘤患者均完全夹闭.术后6个月 日常生活能力(ADL)分级,Ⅰ级73例(36.1％),Ⅱ级87例(43.1％),Ⅲ级32例(15.8％),Ⅳ级5例(2.5％),Ⅴ级3例(1.5％).术后因并发症死亡2例(1.0％).结论 只要病例选择适当,锁孔手术可安全使用于自发性和部分外伤性脑出血患者.
Abstract
Objective To evaluate the application of keyhole surgery in patients with spontaneous intracerebral hemorrhage(ICH)and partial traumatic ICH.Methods A retrospective analysis was conducted on 120 patients with spontaneous ICH,including 96 with hypertensive ICH,15 with aneurysmal rupture hemorrhage,and 9 with arteriovenous malformation rupture hemorrhage,as well as 40 patients with traumatic ICH treated via keyhole surgery.All surgeries were performed within 72 hours of onset.Results Postoperative CT scans conducted within 2-24 hours showed a hematoma clearance rate exceeding 90％in 126 cases(86.8％).Complete clipping was achieved in all 15 aneurysm cases.At 6 months post-surgery,the daily living ability(ADL)grades of the patients were as follows:Grade Ⅰ in 73 cases(36.1％),Grade Ⅱ in 87 cases(43.1％),Grade Ⅲ in 32 cases(15.8％),Grade Ⅳ in 5 cases(2.5％),and GradeⅤ in 3 cases(1.5％).Two patients(1.0％)died due to postoperative complications.Conclusion Keyhole surgery is a safe and effective treatment option for selected patients with spontaneous and partial traumatic ICH.
关键词
锁孔手术/自发性脑出血/外伤性脑出血/临床观察Key words
keyhole surgery/spontaneous cerebral hemorrhage/traumatic cerebral hemorrhage/clinical observa-tion引用本文复制引用
出版年
2025
国家科技期刊平台
NSTL
万方数据