李奎智 雷国亮 张成贵

    [摘要] 目的 探討微创穿刺引流联合开颅减压术治疗高血压脑出血突发脑疝患者的效果及其对脑部血流和预后的影响。 方法 收集2015年10月～2017年10月于石家庄市第一医院神经外科接受手术治疗的96例高血压脑出血突发脑疝患者的临床资料，按照手术方式不同分为在开颅血肿清除及去骨瓣减压术前采用微创穿刺引流治疗的观察组(48例)，常规开颅血肿清除及去骨瓣减压治疗的对照组(48例)。观察记录并比较两组患者经颅多普勒超声(TCD)检查大脑中动脉平均流速(Vm)、大脑中动脉搏动指数(PI)、疗效、神经功能缺损量表(NHISS)评分、格拉斯哥预后评分(GOS)、日常生活能力评定指数(BI)值。 结果 观察组总有效率为91.67%，高于对照组的75.00%，差异有统计学意义(P < 0.05)。两组患者术后7 d、术后1个月及术后3个月的Vm和PI与术前比较，差异均有统计学意义(P < 0.05)。两组患者术后7 d、术后1个月及术后3个月的Vm、PI比较，差异有统计学意义(P < 0.05)；观察组GOS评分情况显著优于对照组，术后3个月观察组BI评分显著高于对照组，差异均有统计学意义(P < 0.05)。 结论 微创穿刺引流联合开颅减压术治疗高血压脑出血突发脑疝的效果、脑血流情况和预后优于常规开颅减压术，是高血压脑出血突发脑疝患者抢救的有效方法。

    [关键词] 微创穿刺引流；高血压脑出血；脑疝；疗效；脑部血流；预后

    [中图分类号] R74.34 [文献标识码] A [文章编号] 1673-7210(2018)05(b)-0050-04

    Effect of minimally invasive puncture drainage combined with craniotomy in the treatment of hypertensive cerebral hemorrhage with sudden cerebral hernia and its effect on cerebral blood flow and prognosis

    LI Kuizhi LEI Guoliang ZHANG Chenggui

    Ward Two of the Department of Neurosurgery， NO.1 Hospital of Shijiazhuang， Hebei Province， Shijiazhuang 050000， China

    [Abstract] Objective To explore the effect of minimally invasive puncture drainage combined with craniotomy in the treatment of hypertensive cerebral hemorrhage with sudden cerebral hernia and its effect on cerebral blood flow and prognosis. Methods Clinical data of 96 hypertensive intracerebral hemorrhage patients with sudden brain hernia from October 2015 to October 2017 were collected. According to the different operation method ......