头颅CT引导下微创穿刺引流术与传统开颅手术治疗婴幼儿颅内出血的对比研究

A Comparative Study of Cranial CT Guided Minimally Invasive Puncture and Drainage and Traditional Craniotomy in the Treatment of Infant with Intracranial Hemorrhage

目的:观察头颅CT引导下微创穿刺引流术在婴幼儿颅内出血中的应用效果。方法:选取2018年7月-2021年6月江西省儿童医院收治的72例颅内出血婴幼儿,按随机数字表法将其分为观察组与对照组,每组36例。对照组行传统开颅手术,观察组在头颅CT引导下行微创穿刺引流术,对比两组患儿的手术情况、术后恢复情况、并发症情况与生存质量情况。结果:观察组手术时间、住院时间短于对照组,清醒时间早于对照组(P<0.05),血肿清除率低于对照组(P<0.05),临床总有效率高于对照组(P<0.05),住院期间并发症的发生率低于对照组(P<0.05),术后随访期间垂体功能低下、轻度残疾、脑积水的发生率均低于对照组(P<0.05)。结论:在婴幼儿颅内出血的治疗中,头颅CT引导下微创穿刺引流术的血肿清除效果虽不及传统开颅手术,但患儿的总有效率更高,且手术具有用时短、术后恢复快、并发症发生率低等特征,可改善颅内出血患儿的生存质量。

Objective:To observe the effect of CT guided minimally invasive puncture and drainage in infants with intracranial hemorrhage.Method:A total of 72 infants with intracranial hemorrhage treated in Jiangxi Provincial Children’s Hospital from July 2018 to June 2021 were selected and divided into observation group and control group according to the random number table method,with 36 cases in each group.The control group received traditional craniotomy and the observation group received minimally invasive puncture and drainage under the guidance of cranial CT.The operation,postoperative recovery,complications and quality of life of the two groups were compared.Result:The operation time and hospitalization time in the observation group were shorter than those in the control group,waking time was earlier than that in the control group(P<0.05),the hematoma clearance rate was lower than that in the control group(P<0.05),the clinical total effective rate was higher than that in the control group(P<0.05),the incidence of complications during hospitalization was lower than that in the control group(P<0.05),and the incidence of pituitary dysfunction,mild disability and hydrocephalus during postoperative follow-up were lower than those in the control group(P<0.05).Conclusion:In the treatment of intracranial hemorrhage in infants,although the hematoma removal effect of minimally invasive puncture and drainage under cranial CT guidance is not as good as that of traditional craniotomy,the total effective rate of children is higher,and the operation has the characteristics of short time,rapid postoperative recovery and low complication rate,which can improve the quality of life of children with intracranial hemorrhage.