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目的 :探讨经颅微创术治疗晚发性维生素 K缺乏性颅内出血的临床疗效。方法 :应用自制小儿脑穿针 ,在 CT定位、定量、定穿刺点下 ,行经颅微创穿刺抽血术治疗颅内血肿 ,合并蛛网膜下腔出血者配合脑脊液置换术 ,并与内科综合治疗组对照研究。结果 :微创组治愈率为 87% (2 0 / 2 3 ) ,总有效率为 1 0 0 % ,无 1例死亡 ,6个月后随访致残率为 7.1 % (1 /1 4) ;对照组治愈率为 2 0 % (4/ 2 0 ) ,总有效率为 6 0 % (1 2 / 2 0 ) ,病死率为 3 0 % (6 / 2 0 ) ,6个月后随访致残率为 77.8% (7/ 9)。两组疗效及致残率经统计学处理 ,有非常显著性差异 (P<0 .0 1 )。结论 :经颅微创术治疗晚发性维生素 K缺乏性颅内出血 ,不仅能显著提高抢救成功率、降低病死率、而且可最大限度地减少致残率 ,提高患儿生存质量
Objective: To investigate the clinical effect of transcranial minimally invasive surgery in the treatment of late onset vitamin K deficiency intracranial hemorrhage. Methods: The homemade cranial intracranial needle was used to treat intracranial hematoma under CT location, quantification and puncture point. The patients with combined subarachnoid hemorrhage and cerebrospinal fluid replacement were treated with combined therapy of internal medicine Group control study. Results: The cure rate of the minimally invasive group was 87% (20/23), the total effective rate was 100%, no one died and the morbidity was 7.1% (1/14) after 6 months. In the control group, the cure rate was 20% (4/20), the total effective rate was 60% (12/2) and the case fatality rate was 30% (6/20). After 6 months follow-up and disability The rate was 77.8% (7/9). The curative effect and disability rate of the two groups were statistically significant, with significant difference (P <0.01). Conclusion: Transcranial minimally invasive surgery for the treatment of late-onset vitamin K deficiency intracranial hemorrhage can not only significantly improve the success rate of rescue and reduce mortality, but also minimize morbidity and improve children’s quality of life