基层医院高血压脑出血个性化微创治疗的临床研究
Clinical study on individualized minimally invasive treatment of hypertensive intracerebral hemorrhage in pri-mary hospital
梁龙 1张传荣 1陈波 1蔡云祥 1郑金荣1
作者信息
- 1. 317502 浙江台州,浙江省肿瘤医院台州院区(台州市肿瘤医院)神经外科、台州市微创介入和大数据人工智能重点实验室
- 折叠
摘要
目的 探讨基层医院高血压脑出血各种微创手术方式的临床效果.方法 选择符合微创手术适应证的56 例高血压脑出血患者,根据不同患者采取个性化手术方式(软通道穿刺、硬通道穿刺、锁孔显微镜下血肿清除、小骨窗内镜下血肿清除、立体定向血肿穿刺抽吸引流术等)进行微创手术,观察疗效.结果 56 例患者术后再出血 4 例,再出血率7.14％.随访3～6 个月,采用日常生活能力(ADL)评定:Ⅰ级8 例、Ⅱ级17 例、Ⅲ级24 例、Ⅳ级2 例、Ⅴ级1 例、死亡4 例(包括3 例因经济及对预后不良难以接受原因放弃治疗),恢复良好率87.50％,死亡率7.14％.结论 基层医院高血压脑出血患者因发病时间短等情况有其特殊性,对符合手术适应证的不同患者采取个性化的微创手术方式进行干预,使得取得良好预后成为可能.
Abstract
Objective To investigate the clinical effects of various minimally invasive surgical procedures for hyperten-sive intracerebral hemorrhage in primary hospitals.Methods A total of 56 patients with hypertensive intracerebral hem-orrhage were selected.According to the different patients,the micro-invasive operation was performed by the individual operation methods(soft-channel puncture,hard-channel puncture,hematoma clearance under the keyhole microscope,he-matoma clearance under the small bone window endoscope,stereotactic aspiration and drainage of hematoma,etc.).The ef-fect was observed.Results Rebleeding occurred in 4 of 56 patients,the rebleeding rate was 7.14％).The patients were followed up for 3-6 months and assessed by activities of daily living(ADL):8 cases were grade Ⅰ,17 cases were grade Ⅱ,24 cases were grade Ⅲ,2 cases were grade Ⅳ,1 case was grade Ⅴ,4 cases died(including 3 cases who gave up treatment because of poor economy and difficult to accept poor prognosis).The recovery rate was 87.50％,and the mortality rate was 7.14％.Conclusion The patients with hypertensive intracerebral hemorrhage in grass-roots hospitals have their own characteristics because of the short time of attack when they come to the hospital.It is possible to achieve a good prognosis by taking individualized micro-invasive surgical intervention to different patients who meet the opera-tion indication.
关键词
高血压/脑出血/微创术/个性化手术Key words
hypertension/cerebral hemorrhage/minimally invasive surgery/personalized surgery引用本文复制引用
基金项目
温岭市科技局项目(2020S018003)
出版年
2024
NETL
NSTL
万方数据