颅内血肿清除术中血肿腔内止血方法效果初步对照研究

A preliminary control study on intracranial hematoma removal the hemostatic effect of hematoma in

目的通过对比两种高血压脑出血颅内血肿清除术中血肿腔内止血方法，并进一步探讨血肿腔内止血的精确性及可靠性。方法前瞻『生研究93例高血压脑出血颅内血肿清除术中，在对血肿腔内进行止血时，试验组采取明胶海绵联合脑棉压迫出血点，对照组采取单纯双极电凝止血方法，术后次日复查CT，计算2组病例的颅内血肿清除率。术后2周行神经功能评估，判断术后2两组病例的运动功能情况。结果两种颅内血肿清除术中血肿腔内止血方法术后血肿清除率分别为87％和79％，2组患者改良Rankin评分良好率分别为72％和64％，差异有统计学意义（P〈0．05）。结论高血压脑出血颅内血肿清除手术中应用明胶海绵联合脑棉压迫出血点的止血方法优于传统的血肿腔内止血方法，能够最大程度清除血肿，同时保护神经功能。

Objective By comparing the two kinds of hypertensive cerebral hemorrhage with intracranial hematoma hematoma cavity hemostasis during operation, and to further explore the hematoma cavity bleeding the accuracy and reliability of beneficial methods for removal of hematoma and retain the greatest degree of nerve function. Methods Prospective study of 93 cases of hypertensive cerebral hemorrhage with intracranial hematoma, bleeding in the hematoma cavity, the experimental group adopted gelatin sponge combined with cerebral hemorrhage control group cotton oppression, take simple bipolar coagulation hemostasis method, postoperative day CT was used in the calculation of two cases of intracranial hematoma clearance. The neurological function was evaluated 2 weeks after operation. The motor function of the patients in the two groups after operation was evaluated. The total hematoma rate and postoperative disability rate of the two groups were statistically analyzed by Fisher precise probability method. Results Two kinds of intraeranial hematoma hematoma cavity hemostasis and postoperative hematoma clearance rate were 87% and 79%, the rate of good score of the two groups of modified Rankin were 72% and 64%, the difference was statistically significant （P 〈0.05）. Conclusion The intracranial hematoma surgery hematoma cavity hemostasis with gelatin sponge combined with cerebral hemorrhage bleeding point compression cotton hypertensive cerebral hemorrhage, hematoma cavity hemostatic method is superior to the traditional, to the greatest extent clearance of hematoma, while protecting the nerve function.