微创置管抽吸液化引流手术与小骨窗开颅血肿清除术治疗脑出血的临床效果对比

Comparison of Clinical Effects Between Minimally Invasive Catheter Aspiration and Liquefaction Drainage Surgery and Small Bone Window Craniotomy for Hematoma Removal in the Treatment of Cerebral Hemorrhage

目的探讨微创置管抽吸液化引流手术与小骨窗开颅血肿清除术治疗脑出血的临床效果。方法选取成武县人民医院2020年1月-2022年12月收治的300例脑出血患者为研究对象,按随机数字表法将其分为对照组与观察组,各150例。对照组行小骨窗开颅血肿清除术,观察组行微创置管抽吸液化引流手术。比较两组患者的神经功能、炎性因子水平、并发症发生情况及生活质量。结果术后1个月,观察组美国国立卫生研究院卒中量表评分低于对照组,纳维亚卒中量表评分高于对照组,组间差异有统计学意义(P<0.05)。术后1周,观察组降钙素原、白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白水平均低于对照组,组间差异有统计学意义(P<0.05)。术后1个月,观察组WHO生活质量测定量表评分低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为3.33%,低于对照组的12.00%,差异有统计学意义(P<0.05)。结论相较于小骨窗开颅血肿清除术,微创置管抽吸液化引流手术治疗脑出血在减轻炎症、改善神经功能方面效果更好,术后并发症少,利于改善生活质量。

Objective To explore the clinical effects of minimally invasive catheterization,aspiration,liquefaction and drainage surgery,and small bone window craniotomy for hematoma removal in the treatment of cerebral hemorrhage.Methods 300 patients with cerebral hemorrhage admitted to Chengwu County People's Hospital from January 2020 to December 2022 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 150 cases in each group.The control group underwent small bone window craniotomy hematoma removal,andthe observationgroup underwentminimally invasive tubeaspiration and liquefaction drainage.Neurological function,inflammatory factors,complications and quality of life were compared between the two groups.Results 1 month after surgery,the score of the National Institutes of Health Stroke Scale in the observation group was lower than that of the control group,and the score of the Navia Stroke scale was higher than that of the control group,with statistical significance(P<0.05).1 week after operation,the levels of procalcitonin,interleukin-6,tumor necrosis factor-α and hypersensitive Creactive protein were lower than those of control group,and the differences between groups were statistically significant(P<0.05).1 month after operation,WHO quality of life scale score was lower than control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 3.33%,lower than 12.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with small bone window craniotomy for hematoma removal,minimally invasive tube aspiration and liquefaction drainage surgery is more effective in reducing inflammation and improving neurological function in the treatment of cerebral hemorrhage.It has fewer postoperative complications and is beneficial for improving quality of life.