CT辅助下软通道引流术治疗脑室出血的有效性及安全性

Efficacy and safety of CT-assisted soft channel drainage in treatment of ventricular hemorrhage

目的 探讨CT辅助下软通道引流术治疗脑室出血(IVH)的有效性及安全性。方法 回顾性分析2017-02至2021-09邢台市第三医院神经外科收治的92例IVH患者的临床资料,根据手术方式不同分为对照组(常规开颅血肿清除术治疗)和观察组(CT辅助下软通道引流术治疗),每组46例,比较两组的临床治疗效果、手术时间、血肿清除时间、住院时间、术后7 d出血量、血肿清除率及术后不良反应,术后随访6个月,应用日常生活活动评定量表(ADL)、改良Rankin评分量表(mRS),评估患者神经功能恢复程度和近期恢复情况。结果 观察组临床疗效好于对照组(89.13%vs. 71.39%),术后不良反应发生率低于对照组(15.21%vs. 34.78%),差异有统计学意义(P<0.05)。观察组手术时间、血肿清除时间、住院时间均短于对照组,术中出血量及血肿清除率均少于或低于对照组,差异有统计学意义(P<0.05),但两组术后7 d出血量和血肿清除率基本相同,差异无统计学意义。术后6个月观察组mRS评分、ADL评分均低于对照组,差异有统计学意义(P<0.05)。结论 CT辅助下软通道引流术治疗IVH效果好,且创伤小、安全性高,可明显改善患者近期预后。

Objective To analyze the efficacy and safety of CT-assisted soft channel drainage in the treatment of ventricular hemorrhage(IVH).Methods The clinical medical records of IVH patients who were admitted to the Neurosurgery Department of the Third Hospital of Xingtai City from February 2017 to September 2021, were retrospectively analyzed. According to surgical methods, the patients were divided into group A(n=46, conventional craniotomy for hematoma evacuation) and group B(n=46, CT-assisted soft channel drainage).The clinical treatment effect, operation time, hematoma clearance time, hospital stay, blood loss of 7 days after operation, hematoma clearance rate and postoperative complications were compared between the two groups. The patients were followed up for 6 months after the operation, and the activities of daily living(ADL) and modified Rankin Scale(mRS) were used to evaluate the degree of neurological recovery and recent recovery of patients.Results The clinical efficacy of group B was better than that of group A(89.13% vs. 71.39%,P<0.05), the incidence of postoperative complications was lower than that of group A(P<0.05), and the operation time, hematoma removal time and hospital stay in group B were shorter than those in group A(P<0.05),the intraoperative blood loss was less than that of group A(P<0.05);The first hematoma clearance rate was lower than that of group A and there was no significant difference in the hematoma clearance rate between the two groups at the time of extubation;the mRS, ADL score of group B was lower than those of group A(P<0.05).Conclusions CT-assisted soft channel drainage for IVH can achieve good results, with less trauma and high safety, and significantly improves the near-term prognosis of patients.