立体定向及显微手术两种术式治疗高血压基底节区脑出血的效果及护理措施

Efficacy of stereotaxis surgery and micro-surgery in treating hypertensive intracerebral basal ganglia hemorrhage and its nursing measures

目的探讨立体定向和显微手术治疗高血压基底节区脑出血的效果。方法选择高血压基底节区脑出血患者100例,随机分成实验组和对照组各50例,对照组患者给予显微手术治疗,实验组患者给予立体定向手术治疗,对2组患者的术中出血量、手术时间、术后再出血率、术后并发症发生情况、术后7 d格拉斯哥昏迷量表(GCS)评分、术后6个月ADL、住院时间、治疗费用等进行对比分析。结果在术后再出血率、血肿清除率、术后7d的GCS评分以及术后6个月ADL等方面,2组患者比较差异无统计学意义(P>0.05);实验组患者在手术时间、术中出血量、术后并发症发生率、住院时间以及治疗费用等方面则显著优于对照组患者,两者比较差异有统计学意义(P<0.05)。结论在临床治疗高血压基底节区脑出血患者时,采用立体定向手术能让手术时间缩短、让术中出血量减少,同时让患者术后并发症发生率降低,缩短住院时间,让治疗费用降低,应用进行临床推广和应用。

Objective To study efficacy of stereotaxis surgery and micro-surgery in treating hypertensive intracerebral basal ganglia hemorrhage and its nursing measures. Methods A total of 100 patients with hypertensive intracerebral basal ganglia hemorrhage were randomized into the control group treated with microsurgery craniotomy and the observation group treated by stereotactic puncture drainage surgery, with 50 patients per group. The volume of blood lose, duration of operation, incidence of rebleeding, postoperative complications, days and cost in hospital were observed and compared. GCS scores and ADL were also observed after surgery in the two groups. Results Compared with the control group, there was no significant difference in incidence of rebleeding, the rate of removal of intracerebral haematoma, GCS scores of 7th day of operation and ADL of 6th month （P 〉0.05）. The volume of blood lose, duration of operation, postoperative complications, days and cost in hospital in the experimental group were significantly decreased （P 〈 0.05）. Conclusion Stereotactie puncture drainage surgery for patients with hypertensive intracerebral basal ganglia hemorrhage can significantly decrease the blooding and operative time, re duce the incidence of postoperative complications as well as days and cost in hospital.