微创穿刺与保守治疗对中等量基底节区出血疗效比较

Comparison of the curative efect of minimally invasive puncture and conservative treatment for moderate-nolume basal ganglia hemorrhage

目的:探讨微创穿刺与保守治疗对中等量基底节区出血的疗效,分析更好的治疗方案。方法:回顾性分析符合入选标准的65例患者资料,根据入组标准分为微创穿刺引组(手术组)39例以及保守治疗组26例,记录治疗后第1、3、7天的血肿体积,早期GCS及NIHSS评分,统计严重并发症情况。出院3个月后mRS评分进行转归评价。结果:手术组患者术后第3天平均残余血肿体积、血肿清除率优于保守组,手术组患者早期GCS、NIHSS评分优于保守组(P<0.001),手术组患者肺部感染发生率低(P<0.001)。手术组患者出院3个月后转归良好率(mRS评分≤2)显著优于保守组(P<0.05),但30天内病死率差异无统计学意义(P=0.3430)。结论:微创穿刺治疗中等量基底节区脑出血疗效优于保守治疗,患者预后及神经功能恢复更好。

Objective:To compare the effectiveness of minimally invasive puncture and conservative treatment for moderate to equal basal ganglia hemorrhage,and to analyze which treatment plan is superior.Method:A retrospective study was carried out on 65 patients who fulfilled the inclusion criteria.Based on the treatment plan,they were categorized into two groups:a minimally invasive puncture surgery group(surgical group)consisting of 39 patients,and a conservative treatment group comprising 26 patients.Key parameters such as hematoma volume,early GCS score,and NIHSS score were documented on the lst,3rd,and 7th days post-admission,and any serious complications during the hospital stay were examined.Three months post-discharge,the patients'outcomes were assessed using the Modified Rankin Scale score(mRS score).Results:The mean residual hematoma volume and hematoma clearance rate 3 days after operation in the surgical group were better than those in the conservative group,the early GCS and NIHSS scores in the surgical group were better than those in the conservative group(P<0.00i),and the incidence of pulmonary infection in the surgical group was lower(P<0.001).The recovery rate(mRS score≤2)at 3 months after discharge was significantly better than that of the conservative treatment group(P<0.05),but there was no significant difference in mortality within 30 days(P=0.3430).Conclusion:Minimally invasive surgery for moderate to moderate basal ganglia hemorrhage is more effective than conservative treatment,and the prognosis and neurological function recovery of patients are better.