微创引流术对脑外伤硬脑膜外血肿患者神经功能的影响

Effects of minimally invasive drainage on never function in patients with extradural hematoma due to brain trauma

目的探讨微创引流术对脑外伤硬脑膜外血肿患者神经功能的影响。方法回顾性分析2016年1月至2017年12月收治的98例脑外伤硬脑膜外血肿患者,根据手术治疗方式不同划分为治疗组50例和对照组48例。对照组给予开颅手术,治疗组采用微创引流术治疗。对比2组患者手术指标,美国国立卫生研究院卒中量表(NHISS)评分、Barthel指数计分、格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)等以及术后并发症发生情况。结果治疗组手术时间、术中出血量、置管时间、住院时间、住院费用均明显低于对照组(P<0.05);术后6个月2组NHISS、GCS、GOS评分均明显优于术后3个月(P<0.05);术后3个月、6个月治疗组NHISS评分均明显低于对照组(P<0.05),GCS、GOS评分均明显高于对照组(P<0.05);治疗组术后中度依赖者、重度依赖者明显少于对照组,轻度依赖者、无需依赖者明显高于对照组;治疗组术后总并发症发生率8.00%明显低于对照组29.17%(P<0.05)。结论微创引流术治疗脑外伤硬脑膜外血肿不仅可改善手术指标,降低术后并发症发生率,还可明显改善患者术后神经功能缺损,提高患者术后独立生活能力,促进术后恢复。

Objective To investigate the effects of minimally invasive drainage on never function in patients with extradural hematoma due to brain trauma. Methods The clinical data about 98 patients with extradural hematoma due to brain trauma who were admitted and treated in our hospital from January 2016 to December 2017 were retrospectively analyzed.These patients were divided into treatment group ( n =50) and control group ( n =48) according to the different surgical treatment methods.The patients in control group were treated by craniotomy,however,the patients in treatment group were treated by minimally invasive drainage.The surgical indexes,National Institutes of Health Stroke Scale (NHISS) score,Barthel index score,Glasgow coma score (GCS),Glasgow prognosis score (GOS),and postoperative complications were observed and compared between the two groups. Results The operation time,intraoperative blood loss,catheterization time, hospitalization time and hospitalization expenses in treatment group were significantly lower than those in control group ( P <0.05),and the scores of NHISS,GCS and GOS in both groups at 6 months after surgery were superior to those at 3 months after surgery ( P < 0.05).Moreover the NHISS scores in treatment group at 3m,6m after surgery were significantly lower than those in control group ( P <0.05),however, the scores of GCS and GOS were significantly higher than those in control group ( P <0.05).In addition the patients with moderate dependence and severe dependence in treatment group were significantly less than those in control group,and those with mild dependence and without dependence in treatment group were significantly more than those in control group,besides, the incidence rate of postoperative complications in treatment group was 8.00%,which was significantly lower than that (29.17%) in the control group ( P <0.05). Conclusion Minimally invasive drainage in treatment of extradural hematoma due to brain trauma can not only improve the surgical indexes,reduce the incidence rate of postoperative complications,but also can significantly improve the postoperative neurologic impairment,improve the patient's postoperative independent living ability,and promote postoperative recovery.