无脑压板技术在自发性脑内出血手术中的应用

Retractorless surgery for spontaneous intracerebral hemorrhage

目的:评估自发性脑内出血手术中应用无脑压板技术的安全性和有效性。方法:回顾分析2013年1月至2015年12月56例采用无脑压板技术治疗自发性脑内出血患者的临床资料,并与同期59例采用固定脑压板技术治疗的患者进行比较。观察两组患者脑牵拉伤发生率、血肿清除率、再出血率、手术时间、90d改良Rankin评分、病死率。结果:无脑压板组所有手术均未使用脑压板而成功完成手术(完成率100%)。两组患者的血肿清除率、再出血率、手术时间和病死率差异均无统计学意义。无脑压板组脑牵拉伤发生率明显低于固定脑压板组(P<0.01)。无脑压板组90dmRS评分明显优于固定脑压板组。结论:在自发性脑内出血患者手术中,无脑压板技术能减少脑压板导致的脑牵拉伤,改善患者预后。

Objective ： To assess the safety and efficacy of retractorless surgery in spontaneous intracerebralhemorrhage. Methods： Fity-six cases of spontaneous intracerebral hemorrhage treated by retractorless surgery and 59 casestreated by retractor surgery from January 2013 to December 2015 were included. Brain retraction injury rate, hematomaremoval rate, rebleeding rate, operation time, 90-day modified Rankin score and mortality rate were observed in the twogroups. Results ： All operations in the retractorless group were successfully completed without the retractor. There was nosignificant difference in hematoma removal rate, rebleeding rate, operation time and mortality between the two groups. Thebrain retraction injury rate in the retractorless group was significantly lower than that in the retractor group （P〈0. 01）. 90-daymodified Rankin score in the retractorless group was significantly better than that in the retractor group. Conclusions ：Retractorless surgery can not only reduce the brain retraction injury, but also improve the prognosis of patients withspontaneous intracerebral hemorrhage in the operation of spontaneous intracerebral hemorrhage.