微创穿刺术在外伤性脑出血中的应用

Application of Mini-invasive Puncture for Traumatic Intracranial Hemorrhage

目的探讨微创穿刺术治疗外伤性脑出血的疗效。方法外伤性脑出血患者72例,随机分为微创组和开颅组,微创组接受微创穿刺术,开颅组采用骨瓣开颅血肿清除术。结果微创组平均住院时间明显少于开颅组,呼吸道感染、消化道出血以及电解质紊乱发生率明显低于开颅组(P<0.05);微创组昏迷患者平均清醒时间明显少于开颅组(P<0.05)。微创组总有效率为88.9%,开颅组为75.0%。结论微创清除术治疗外伤性脑出血具有创伤小,操作简单,适应证广等诸多优点,临床医师应严格掌握手术操作要点并积极推广应用。

Objective To investigate the clinical effect of mini-invasive puncture for traumatic intracranial hemorrhage. Method 72 cases with traumatic intracerebral hemorrhage were randomized into two groups, with 36 cases for each： mini-invasive group was performed pucture and hematoma aspiration, and craniotomy group was cleared the hematoma by craniotomy. Results The hospital stay time and recovery time from coma was （ 11.1 ± 2.5 ） days and （ 3.5 ±1.1 ） days respectively in mini-invasive group, and both was shorter than （19.2 ±2.7） days and （5.6±1.2） days ofcraniotomy group （ P 〈 0.05 ）. The rates of respiratory tract infection, gastrointestinal hemorrhage, and electrolyte disturbance was 11.1% , 8.3% and 5.6% respectively in mini-invasive group, and were lower than 38.9% , 27.8% and 25.0% of craniotomy group （ P 〈 0.05 ）. The total effective rate was 88.9% in mini-invasire group and 75.0% in craniotomy group. Conclusions Mini-invasive puncture is deserve to popularize for traumatic intracerebral hemorrhage with advantages as mini-trauma, simple, and wide indications. Neverthe- less, operative highlights of the procedure must be abided strictly.