微创钻孔引流术在高血压脑出血中的应用价值研究

Application value of minimally invasive drainage in hypertensive cerebral hemorrhage

目的探讨微创钻孔引流术在高血压脑出血中的应用价值。方法选取自2015年1月至2016年5月廊坊爱德堡医院脑外科收治的68例高血压脑出血患者作为研究对象,其中36例行微创钻孔引流术(微创组),32例行骨瓣开颅血肿清除术(开颅组),比较2组手术疗效、手术时间、住院时间、再出血率,采取GOS评分对2组患者的预后进行评估,同时采取神经功能缺损评分、日常生活活动能力评分量表(ADL)对2组患者术前、术后3个月神经功能恢复情况以及日常生活活动能力改善情况进行评估。结果微创组总有效率为91.67%,与开颅组的65.63%相比有明显上升,差异具有统计学意义(P<0.05);微创组患者手术时间、住院时间均明显短于开颅组,差异具有统计学意义(P<0.05);2组再出血率比较,差异无统计学意义(P>0.05);微创组术后预后良好率为86.11%,与开颅组的56.25%相比,差异具有统计学意义(P<0.05);2组患者术后3个月神经功能缺损评分较术前有明显下降,ADL评分明显上升,差异具有统计学意义(P<0.05);但微创组神经功能缺损评分、ADL评分改善程度均明显大于开颅组,差异具有统计学意义(P<0.05)。结论微创钻孔引流术治疗高血压脑出血可有效促进神经功能恢复,改善患者预后,疗效确切且安全性高。

Objective To explore the application value of minimally invasive puncture drainage in hypertensive cerebral hemorrhage. Methods Sixty-eight cases of hypertensive cerebral hemorrhage admitted to Langfang edburg Hospital Department of Neurosurgery from January 2015 to May 2016 were selected as the research objects,36 cases of minimally invasive drilling drainage（minimally invasive group）,32 cases of bone flap craniotomy hematoma removal（craniotomy group）. The operation effect,operation time,length of stay,and bleeding rate of the two groups were compared,and the prognosis were evaluated by GOS score,at the same time,nerve function defect score and daily life ability scale（ADL） were adopted to evaluate the recovery of neurological function and activities of daily living in the two groups before and after 3 months. Results The total effective rate of minimally invasive group was91.67%,which was significantly higher than that of the 65.63% craniotomy group,the difference was statistically significant（P〈0.05）. The operation time and length of stay in the minimally invasive group were significantly shorter than that in the craniotomy group,the difference was statistically significant（P〈0.05）. There was no significant difference in the rate of rebleeding between the two groups（ P〈0.05）.The prognosis of minimally invasive group was 86.11%,compared with the craniotomy group of 56.25%,the difference was statistically significant（P〉0.05）. The neurological function defect scores of the two groups were significantly decreased,and the ADL score was significantly increased after 3 months,the difference was statistically significant（P〈0.05）. But the neurological function defect score and ADL score were significantly higher in the minimally invasive group than that in the craniotomy group,the difference was statistically significant（P〈0.05）. Conclusion Minimally invasive surgical treatment of hypertensive cerebral hemorrhage can effectively promote the recovery of neurological function,improve prognosis,the curative effect is exact and the safety is high.