|
|
Comparison of curative effects of two methods of surgical treatment for large area hypertensive cerebral hemorrhage in elderly |
LIU Guodong,CUI Fengqi,WANG Shouli,and YAN Limin |
Department of Neurosurgery,Liangxiang Hospital of Fangshan,Beijing 102488,China |
|
|
Abstract Objective To find a suitable method for the treatment of large area hypertensive cerebral hemorrhage in the elderly.Methods Retrospective analysis was made of 112 elderly patients with large area hypertensive cerebral hemorrhage. Treatment of traditional bone flap craniotomy and drilling drainage were used. The rates of consciousness recovery in a week after the operation, the rates of postoperative bleeding again, the rates of postoperative complications(pulmonary infection) in two weeks, in-hospital mortality, MRS(Modified Rankin Scale) scores at 30 days after surgery, MRS scores at 3 months after surgery for the two groups were measured and compared.Results The rates of consciousness recovery in a week after the operation were 74.07% and 43.10%, the rates of pulmonary infection in two weeks were 9.26% and 25.86%,and the rates of tracheotomy after the operation were 3.70% and 10.34%,with significant difference(P<0.05), patients with drilling drainage were much better than the patients with traditional bone flap craniotomy. There were significant differences in the MRS scores at 30 days after surgery(χ2=18.907,P=0.002) and MRS scores at 3 months after surgery(χ2=12.642,P=0.027), patients with drilling drainage were also much better.Conclusions Drilling drainage is a simple and effective method for the treatment of hypertensive cerebral hemorrhage. It damages the brain tissue less. It reduces the incidence of postoperative complications compared with the traditional bone flap craniotomy surgery. Patients can regain consciousness early after the operation, which undoubtedly helps patients recover early. So drilling drainage is the preferred treatment for large area hypertensive cerebral hemorrhage in the elderly.
|
Received: 11 November 2015
|
|
|
|
|
[1] |
McKissock W,Richardson A,Taylor J.Primary intracerebral haemorrhage:A controlled trial of surgical and conservative treatment in 180 unselected cases[J].Lancet,1998,2:221-226.
|
[2] |
Backlund E D,Holst V H.Controled subtotal evacuation of intracerebral hematomas by stereotactic technique[J].Surg Neurol,1978, 9(2):99-101.
|
[3] |
Prasad K, Browman G, Srivastava A, et al. Surgery in primary supratentorial intracerebral hematoma: a meta-analysis of randomized trials[J]. Acta Neurol Scand, 1997, 95(2):103-110.
|
[4] |
Ming Liu, Bo Wu, Wenzhi Wang, et al. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol,2007,6: 456–464.
|
[5] |
梁子聪,曾 松,陈 进,等.不同术式对高血压脑出血老年患者预后的影响[J].中国临床神经外科杂志,2010,15(6):372-373.
|
[6] |
何小平,牛小亚.大量出血的老年性高血压脑出血患者微创手术治疗体会[J]. 中国临床研究, 2015, 28(4):469-471.
|
[7] |
喇新军.老年性高血压脑出血手术治疗预后的影响因素[J].航空航天医药,2009,20(2):101-102.
|
[8] |
肖 娟,赵建红,李连生.颅内血肿微创清除术治疗急性脑出血最佳手术时机探讨[J].河北医药,2010,32(14):1901-1902.
|
[9] |
洁 丹,邵书梅.颅内血肿微创穿刺粉碎清除术后再出血的临床分析[J].中国实用神经疾病杂志,2008,11(2):137-138.
|
[10] |
有 安.微创穿颅血肿清除术临床相关问题的探讨[J].中风与神经疾病杂志,2003,20(3):270-271.
|
[11] |
杨冰霞,杨 标,郑越瑜,等.早期康复训练对脑出血偏瘫患者患肢功能及日常生活活动能力的影响[J].广东医学院学报,2009,27(3):290-291.
|
|
|
|