| 摘要: |
| 目的探讨术中超声结合头颅CT在高血压脑出血手术中的辅助作用,从而分析其在脑出血术中的应用价值与患者预后的关系。方法在显微外科手术的基础上,将65例高血压脑出血患者随机分为A、B两组,A组34高血压脑出血患者在手术中接受了术中超声检查,在对脑内血肿位置进行定位,同时计算血肿范围大小及距离硬膜的距离,决定最佳手术入路。然后采用彩色多普勒技术对血肿内部及周边血流情况进行探查,以了解是否存在大动脉、动静脉畸形(AVM)等并即时避让或止血处理。在手术过程中还需随时应用超声,实时引导修正手术路径,寻找残余血肿。B组31例行常规手术,然后比较两组患者血肿清除情况及治疗效果。结果 A组颅内血肿完全清除率为91.16%,明显高于B组(70.97%,两组相比较差异有统计学意义(P<0.05)。术后7d GCS评分及术后脑梗死发生率与预后之间有差异,术后1个月及6个月,A组疗效优于B组(均P<0.05)。结论采用术中超声技术不仅能准确定位血肿位置、彻底清除脑内血肿、减少脑组织损伤及降低手术并发症的发生,从而提高手术安全性及治疗效果。 |
| 关键词: 高血压脑出血 小骨窗开颅 术中超声 预后 |
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| The Application Value of Intraoperative Ultrasound and Prognosis in the Treatment of Hypertensive Intracerebral Hemorrhage by Small Bone Window Craniotomy and Hematoma Removal |
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Yao Wenhua;Zhu Chengming;Liu Li1,2
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1.Ultrasonic Section of the People’s Hospital of Ya’an City;2.Neurosurgery Ward of Beijing Tiantan Hospital
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| Abstract: |
| Objective To investigate the effect of intraoperative ultrasound combined with skull CT on hypertensive intracerebral hemorrhage,and to analyze the relationship between the application value and prognosis of patients with intracerebral hemorrhage.Methods On the basis of microsurgical operation,65 patients with hypertensive intracerebral hemorrhage were randomly divided into group A and group B.In group A,34 patients with hypertensive intracerebral hemorrhage underwent intraoperative ultrasound examination during surgery to locate the location of hematoma in the brain. At the same time,the size of the hematoma and the distance from the dura were calculated,and the best surgical approach was determined.Color Doppler techniques were then used to investigate the blood flow inside and around the hematoma,so as to understand the presence of major artery,arteriovenous malformation( AVM),etc and to avoid or stop bleeding in time.In the course of operation,ultrasound should be used at any time,and the operative path should be corrected in real time to search for residual hematoma.In group B,31 patients were performed routine surgery,and then the hematoma clearance and treatment effect were compared between the two groups. Results The complete clearance rate of intracranial hematoma in group A was 91. 16%,which was significantly higher than that in group B 70. 79%,and the difference between the two groups was statistically significant( P < 0.05). There were significant differences in GCS score,incidence of cerebral infarction and prognosis 7 days after operation( P<0.05).1 month and 6 months after operation,the curative effect of group A was better than that of group B( P< 0.05). Conclusion The use of intraoperative ultrasonic technique can not only accurately locate the location of hematoma,thoroughly clear the hematoma,reduce the injury of brain tissue and reduce the occurrence of operative complications,so as to improve the safety and therapeutic effect of the operation |
| Key words: hypertensiveintracerebralhemorrhage smallbonewindowcraniotomy intraoperativeultrasound prognosis |
