显微镜下锁孔手术对高血压脑基底节出血患者意识恢复和远期生存率的影响

目的 探讨显微镜下锁孔手术对高血压脑基底节出血患者意识恢复和远期生存率的影响.方法 选取咸阳市中心医院2012年1月—2013年10月收治的高血压脑出血患者63例为研究对象,根据治疗方法不同分为观察组(32例)和对照组(31例),观察组行显微镜下锁孔手术,对照组行传统骨瓣开颅手术,观察并记录两组血肿消除情况、意识恢复、神经功能恢复、并发症和远期生存率等指标.结果 两组血肿清除率比较差异无统计学意义(P>0.05);治疗2周后观察组意识恢复良好率为78.2%,显著高于对照组的41.9%(P<0.01);治疗2个月后观察组神经功能恢复总有效率65.7%明显高于对照组38.7%(P<0.05);两组术后并发症发生率差异无统计学意义(P>0.05);住院期间观察组血肿复发率6.25%明显低于对照组25.8%(P<0.05);观察组术后6个月、1年、2年及3年的生存率略高于对照组,但两组间比较差异无统计学意义(P>0.05).结论 显微镜下锁孔手术治疗高血压基底节区出血能够显著改善意识功能和神经功能恢复,但对远期生存率无明显影响.

Effects of Keyhole Surgery under Microscope on Consciousness Recovery and Long-term Survival Rate of Pa-tients with Hypertensive Basal Ganglia Hemorrhage

Objective To investigate effects of keyhole surgery under microscope on consciousness recovery and long-term survival rate of patients with hypertensive basal ganglia hemorrhage. Methods A total of 63 patients with hy-pertensive basal ganglia hemorrhage admitted during January 2012 and September 2013 were divided into observation group (n=32) and control group (n=31) according to the different methods for treatment. Observation group was given keyhole surgery under microscope, while control group was treated with traditional bone flap craniotomy. Indexes such as hematoma elimination, consciousness recovery, neurological function recovery, complications and long-term survival rate of patients were observed and compared in two groups. Results There was no significant difference in hematoma clear-ance rate between two groups (P>0. 05). Fine rate of consciousness recovery in observation group (78. 2%) was signif-icantly higher than 41. 9% in control group 2 weeks after treatment (P<0. 01). The total effective rate of neurological function recovery in observation group (65. 7%) was significantly higher than 38. 7% in control group 2 months after treatment (P<0. 05). There was no significant difference in incidence rate of postoperative complications between two groups (P>0. 05). During hospital stay, recurrence rate of hematoma in observation group (6. 25%) was significantly lower than 25. 8% in control group (P<0. 05). The survival rates of 6 months, 1 year, 2 years and 3 years after surgery in observation group were slightly higher than those in control group, but there were no significant differences between two groups (P>0. 05). Conclusion Keyhole surgery under microscope in treatment of hypertensive basal ganglia hemor-rhage can significantly improve consciousness function and recovery of neurological function, but it can not affect long-term survival rate.