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穿刺引流术对脑出血后脑水肿及预后的影响
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穿刺引流术对脑出血后脑水肿及预后的影响
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Journal Article
穿刺引流术对脑出血后脑水肿及预后的影响
2011
Overview
目的探讨基底节高血压脑出血后穿刺引流术和药物保守洽疗对脑水肿及预后的影响。方法基底节高血压脑出血患者62例，随机接受经额叶血肿穿刺引流术（微创组）或单纯药物治疗（对照组）。分别于治疗第3和14天时评价治疗前后血肿和脑水肿体积改善程度、再出血发生率、血肿完全吸收时间，以及微创组患者血肿引流时间、血肿清除率、手术后并发症和手术安全性。结果住院期间两组患者均未发生再出血，对照组有6例患者（20％）于治疗开始3d内因严重脑水肿致脑疝形成改行开颅血肿清除术，微刨组穿刺引流术后无一例发生穿刺相关性脑出血、颅内感染及死亡。微创组患者血肿完全吸收时间[（7．41±5．84）d]短于对照组[（23．15±8．49）d]，差异具有统计学意义（t=9．897，P=0．000）。治疗第3天时两组患者脑水肿体积比较，对照组[（58．42±11．56）ml]明显大于微创组[（8．47±7．76）ml]，差异有统计学意义（t=20．242，P=0．000）；治疗后6个月时，两组患者预后良好率比较，微创组（30例，93．75％）优于对照组（20例，66．67％；P=0．007）。结论穿刺引流术可减轻脑出血后脑水肿程度，具有促进患者神经功能恢复的良好作用。
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