多点穿刺联合局部亚低温灌洗引流治疗老年重症高血压脑出血的效果

Abstract
Figure/Table
References (19)
Related Citation (3)

Download: PDF (0 KB) HTML (34 KB)
Export: BibTeX | EndNote (RIS)

Abstract ObjectiveTo explore the effect of multi-point puncture plus local hypothermia drainage(MPPLHD)treating the elder severe hypertensive intracerebral hemorrhage.MethodsFrom June 2011 to December 2016,81 elder patients with severe hypertensive intracerebral hemorrhage were selected as object and they were divided into MPPLHD group(n=37)and conventional craniotomy group (CC group,n=44)according to the patient situation and family wishes.In CC group,removal of hematoma by standard large bone flap craniotomy was adopted.MPPLHD group was treated with MPPLHD.Hematoma clearance rate,intracranial pressure,brain edema with considerable increment at the third,fifth,seventh day,blood NSE concentration,neurological deficit score(NDS)and activity of daily living(ADL)score were compared between the two groups.ResultsThe first hematoma evacuation rate in MPPLHD group was lower than that in the CC group (P＜0.05）,the hematoma evacuation rate after the third,fifth day operation in MPPLHD group was higher than those in CC group (P＜0.05).Brain edema with considerable increment at the third,fifth,seventh day and blood NSE concentration in MPPLHD group were obviously lower than that of CC group(P＜0.05).After 28 days,3 and 5 months operation,NDS and ADL score in MPPLHD group were better than those of CC group (P＜0.05).ConclusionMPPLHD can effectively remove hematoma and reduce the loss of postoperative nerve function.It is an effective method for the treatment of elder severe hypertensive cerebral hemorrhage.

Key words： Multi-point puncture Hypertensive intracerebral hemorrhage Local hypothermia Drainage

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Liang
	YUAN Ding
	DONG Wei
	CHEN Guo
	CHEN Zhi-qiang

Cite this article:

WANG Liang,YUAN Ding,DONG Wei, et al. Effect of multi-point puncture plus local hypothermia drainage treating the elder severe hypertensive intracerebral hemorrhage[J]. 中国当代医药, 2018, 25(4): 60-63.

URL:

http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I4/60

[1]	王亮.超早期微创穿刺引流术治疗轻型基底节区脑出血（附 41 例报告）[J].中国神经精神疾病杂志，2011，5（3）：309-311.
[2]	王亮，袁丁，孙晓川.双针穿刺治疗老年重症基底节区脑出血[J].中华神经外科疾病研究杂志，2017，16（4）：356-358.
[3]	Sato S，Carcel C，Anderson CS.Blood pressure management after intracerebral hemorrhage[J].Curr Treat Options Neurol，2015，17（12）：49-52.
[4]	Manning LS，Robinson TG.New insights into blood pressure control for intracerebral haemorrhage[J].Front Neurol Neurosci，2015，12（4）：3735-3750.
[5]	Cai X，Rosand J.The evaluation and management of adult intracerebral hemorrhage[J].Semin Neurol，2015，35（6）：638-645.
[7]	陈清棠.脑卒中神经功能损害程度评分标准[J].中华神经科杂志，1998，21（1）：60-63.
[6]	Liu Z，Chen Q，Tian D，et al.Clinical significance of dynamic monitoring by transcranial doppler ultrasound and intracranial pressure monitor after surgery of hypertensive intracerebral hemorrhage[J].Int J Clin Exp Med，2015，8（7）：11456-11462.
[8]	Ding D.Role of surgical evacuation in the management of giant hypertensive intracerebral hemorrhage[J].Clin Neurol Neurosurg，2013，115（12）：255-259.
[9]	Takeuchi S，Takasato Y，Masaoka H.Decompressive craniectomy with hematoma evacuation for large hemispheric hypertensive intracerebral hemorrhage[J].Acta Neurochir Suppl，2013，1（18）：277-279.
[10]	Gao XY，Huang JO，Hu YF，et al.Combination of mild hypothermia with neuroprotectants has greater neuroprotective effects during oxygen-glucose deprivation and reoxygenation-mediated neuronal injury[J].Sci Rep，2014，12（5）：47-91.
[11]	Cechmanek BK，Tuor UI，Rushforth D，et al.Very mild hypothermia（35℃） postischemia reduces infarct volume and blood/brain barrier breakdown following tPA treatment in the mouse[J].Ther Hypothermia Temp Manag，2015，5（4）：203-208.
[12]	Gunn AJ，Thoresen M.Animal studies of neonatal hypothermic neuroprotection have translated well in to practice[J].Resuscitation，2015，10（3）：9788-9790.
[13]	Girisgin AS，Kalkan E，Ergin M，et al.An experimental study：does the neuroprotective effect increase when hypothermia deepens after traumatic brain injury?[J].Iran Red Crescent Med J，2015，17（4）：212-233.
[14]	Wang J，Pearse DD.Therapeutic hypothermia in spinal cord injury：the status of its use and open questions[J].Int J Mol Sci，2015，16（8）：16848-16879.
[15]	Brandon Westover M，Ching S，Kumaraswamy VM，et al.The human burst suppression electroencephalogram of deep hypothermia[J].Clin Neurophysiol，2015，126（10）：1901-1914.
[16]	Kim JH，Seo M，Han HS.The neurovascular protection afforded by delayed local hypothermia after transient middle cerebralarteryocclusion[J].CurrNeurovascRes，2013，10（2）：134-143.
[17]	Vipin A，Kortelainen J，Al-Nashash H，et al.Prolonged local hypothermiahasnolong-termadverseeffectonthespinalcord[J].Ther Hypothermia Temp Manag，2015，5（3）：152-162.
[18]	Dey M，Stadnik A，Awad IA.Spontaneous intracerebral and intraventricular hemorrhage：advances in minimally invasive surgery and thrombolytic evacuation，andlessons learned in recent trials[J].Neurosurgery，2014，7（4）：142-150.
[19]	Mould A，Carhuapoma R，Muschelli J，et al.Minimally invasive surgery plus rt-PA for intracerebral hemorrhage evacuation（MISTIE） decrease perihematomal edema[J].Stroke，2013，44（3）：627-634.