微创治疗高血压脑出血术后并发症临床分析

Clinical analysis on postoperative complications of minimally invasive treatment in patients with hypertensive cerebral hemorrhage

目的探讨微创治疗高血压脑出血术后常见的并发症及其防治方法。方法选取我院从2006年6月到2013年6月接受微创治疗的高血压脑出血患者152例,分为钻孔引流组以及小骨窗开颅组,回顾性总结微创术后并发症的种类,两组进行对比,分析其发生原因,提出相关防治措施。结果微创治疗高血压脑出血术后常见并发症有肺部感染、颅内再出血、消化道出血、颅内积气、颅内感染、电解质紊乱、急性肾损伤、泌尿系感染。对两组患者微创术后并发症进行统计学分析显示:钻孔引流组发生颅内再出血大于小骨窗开颅组(P<0.05),小骨窗开颅组发生颅内积气大于钻孔引流组(P<0.05),有统计学意义。而在微创术后两组患者发生肺部感染、电解质紊乱、消化道出血、颅内感染、急性肾损伤、泌尿系感染诸方面差异无统计学意义(P>0.05)。结论微创治疗高血压脑出血的患者术后并发症较多,应尽早发现和预防,有重点地积极给予治疗,以改善预后,促进康复。

Objective：To discuss the prevention and therapy on the complications after minimally invasive treatment in hypertensive hemorrhage patients. Methods We reviewed 152 cases after minimally invasive treatment in hypertensive hem- orrhage from June 2006 to June 2011. The eases were divided into minimally invasive trepanation ＆ drainage and craniotomy group with small bone window craniotomy group. Complications after minimally invasive treatment were retrospectively sum- marized. The causes of complications were comparatively analyzed to propose the prevention methods. Results Complica- tions of HICH are lung infection, intracranial bleeding, gastrointestinal bleeding, intracranial pneumatosis, intracranial in- fection, electrolyte imbalance, acute kidney injury, urinary tract infection, infection, brain and heart syndrome, electrolyte disturbance in HICH. statistical analysis showed small bone window craniotomy group possessed lower intracranial bleeding rate than trepanation ＆ drainage（ P 〈0.05）, while trepanation ＆ drainage group possessed lower intracranial pneumatosis rate than small bone window craniotomy group （ P 〈 0.05 ）. There were no significantly differanees in Lung infection, in- tracranial bleeding, gastrointestinal bleeding, intracranial pneumatosis, intracranial infection, electrolyte imbalance, acute kidney injury, urinary tract infection between two groups. Conclusions Early prevention and detection and focused treatment should be given to decrease the postoperative complications of minimally invasive treatment in hypertensive hemorrhage pa- tients.