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ID:33401068
大小:1.21 MB
页数:35页
时间:2019-02-25
《微创穿刺术治疗大量脑出血的临床效果》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、重庆医科大学硕士学位论文微创穿刺术治疗大量脑出血的临床效果姓名:赖智勇申请学位级别:硕士专业:神经病学指导教师:李光勤201204重庆医科大学硕士研究生学位论文微创穿刺术治疗大量脑出血的临床效果摘要背景脑出血是一种严重的急性脑血管疾病,其发病率、死亡率和致残率均高。而内科保守治疗及传统外科开颅手术的疗效均不令人满意。近年来,微创穿刺术的出现给治疗脑出血带来了曙光。但关于微创穿刺术对大量脑出血患者疗效的研究较少。所以,本研究拟观察微创穿刺术治疗大量脑出血的疗效,为临床工作提供证据。目的比较微创穿刺术与内科保守治疗对大量脑出血的疗效,观察微创穿刺术的临
2、床效果。方法收集2008年1月~'2010年12月期间在重庆医科大学附属第一医院神经内科住院治疗的大量脑出血患者。根据研究标准总共入选患者53例,将其随机分为手术组和对照组,手术组23例患者,采用微创穿刺术治疗,对照组30例患者,采用内科保守治疗。治疗30d后比较两组的治疗效果及并发症情况。结果手术组的病死率明显低于对照组(34.78%VS63.33%),两组比较差异有统计学意义(P3、————————————————一昏迷评分(GCS)<9分的患者死亡率均为100%。两组患者30d的有效率、Barthel指数(BI)得分及并发症发生率比较,差异没有统计学意义(P>O.05)。结论微创穿刺术可减少大量脑出血患者的病死率,是一种简单易行且微创的治疗方法。但对于血肿量≥80ml或GCS评分<9分的患者疗效较差。关键词:脑出血,微创穿刺术,预后EFFECTOFMINIMALLYINVASIVEASPIRATIONINTREATMENTOFMASSIVEINTRACEREBRALHEMoRRHAGEABSTRACTBackgroundIn4、tracerebralhemorrhageisaseriousacutecerebrovasculardiseasewith11i曲incidence,mortalityanddisability.Theefficacyoftraditionalconservativeapproachandconventionalopencraniotomyhavebeenverydisappointing.Recently,meappearallceoftlleminimallyinVasiveaspirationhaslightenedthetreatment5、ofintracerebralhemorrhage.Howevertherearefewsmdiesontheminimallyinvasiveaspirationinpatientswithmassiveintracerebralhemorrhage.So,weplannedtOexaminetheeffectofthemillimallyinvasiveaspirationformassiveintracerebralhelnorrhageandprovidedusefiflinformationforclinicalworkObjective6、TocomparetheefficacyoftheminimallymvasiveaspirationandtraditionalconservativeapproachinpatientswithmassiveintracerebralhemorrhageandexploretheclinicaltherapeuticeffectoftheminimallyinvasiveaspirationMethods4Atotalof53patientswithmassiveintracerebralhelnorrhageinthedepanmentofn7、铋rolo科oftlleFirstA瓶1iatedHospital,ChongqingMedicalUniversityfromJanuary2008toDecember2010wereenrolledinthisstudybasedoninclusionandexclusioncriteria.Thesepatientswererandomlydividedintooperationgroup(n=23)andcomrolgroup(n230)accordingtotreatmentmethod.Patientsinoperationgroupw8、eretreatedwiththeminimallyinvasiveaspiration,whilepatientsinc
3、————————————————一昏迷评分(GCS)<9分的患者死亡率均为100%。两组患者30d的有效率、Barthel指数(BI)得分及并发症发生率比较,差异没有统计学意义(P>O.05)。结论微创穿刺术可减少大量脑出血患者的病死率,是一种简单易行且微创的治疗方法。但对于血肿量≥80ml或GCS评分<9分的患者疗效较差。关键词:脑出血,微创穿刺术,预后EFFECTOFMINIMALLYINVASIVEASPIRATIONINTREATMENTOFMASSIVEINTRACEREBRALHEMoRRHAGEABSTRACTBackgroundIn
4、tracerebralhemorrhageisaseriousacutecerebrovasculardiseasewith11i曲incidence,mortalityanddisability.Theefficacyoftraditionalconservativeapproachandconventionalopencraniotomyhavebeenverydisappointing.Recently,meappearallceoftlleminimallyinVasiveaspirationhaslightenedthetreatment
5、ofintracerebralhemorrhage.Howevertherearefewsmdiesontheminimallyinvasiveaspirationinpatientswithmassiveintracerebralhemorrhage.So,weplannedtOexaminetheeffectofthemillimallyinvasiveaspirationformassiveintracerebralhelnorrhageandprovidedusefiflinformationforclinicalworkObjective
6、TocomparetheefficacyoftheminimallymvasiveaspirationandtraditionalconservativeapproachinpatientswithmassiveintracerebralhemorrhageandexploretheclinicaltherapeuticeffectoftheminimallyinvasiveaspirationMethods4Atotalof53patientswithmassiveintracerebralhelnorrhageinthedepanmentofn
7、铋rolo科oftlleFirstA瓶1iatedHospital,ChongqingMedicalUniversityfromJanuary2008toDecember2010wereenrolledinthisstudybasedoninclusionandexclusioncriteria.Thesepatientswererandomlydividedintooperationgroup(n=23)andcomrolgroup(n230)accordingtotreatmentmethod.Patientsinoperationgroupw
8、eretreatedwiththeminimallyinvasiveaspiration,whilepatientsinc
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