针钻一体穿刺治疗重症高血压脑出血的临床观察

Study on the treatment of severe hypertensive cerebral hemorrhage by the operation with integrative needle and drill

目的观察应用针钻一体穿刺治疗重症高血压脑出血的疗效。方法对50例重症高血压脑出血患者（治疗组）采用微创穿刺结合早期系统的康复治疗，并以49例常规治疗患者作为对照组。结果（1）治疗组生存37例，对照组生存28例；治疗组生存患者治疗4周后格拉斯哥昏迷评分（GCS）明显高于对照组（P〈0．01）。（2）功能独立性评价量表（FIM）评分治疗组和对照组入院时[（58±12）分比（60±11）分]及治疗第14天[（64±13）分比（62±12）分]差异无统计学意义（P〉0．05），但治疗第1个月[（76±16）分比（65±14）分]及第3个月[（904-22）分比（69．4-18）分]时治疗组FIM评分均显著优于对照组（P〈O．05）。（3）美国国立卫生研究院卒中量表（NIHSS）评分入院时治疗组[（17．5±3．5）分]和对照组[（16．9±3．4）分]比较差异无统计学意义（P〉O．05），康复治疗第14天[（14．3±3．3）分比（16．2±3．5）分]、第1个月[（12．1±2．4）分比（15．7±3．4）分]、第3个月[（9．0±3．4）分比（12．2±3．6）分]时治疗组NIHSS评分显著优于对照组（P〈0．05）。结论微创穿刺治疗重症高血压脑出血安全有效，疗效优于常规内科治疗。

Objective To observe the effect of severe hypertensive cerebral hemorrhage with minimally invasive technology. Method Fifty patients of severe hypertensive cerebral hemorrhage treated by minimally invasive puncture combined early systemic rehabilitation （treatment group）, and 49 patients with conventional treatment as control group. Results （ 1 ）The survival number were 37 cases in treatment group and 28 cases in control group. The survival patients with GCS after 4 weeks in treatment group was significantly higher than that in control group （P 〈 0.01 ）. （2） FIM score of treatment group and control group on admission [（58 ± 12） scores vs （60-± 11 ） scores] and the 14 th day [（64 ± 13） scores vs （62 ± 12） s±ores ] after treatment, there was no significant difference （P 〉 0.05 ）, but the FIM score of treatment group at the first month [ （76 ± 16 ） scores vs （65 ± 14 ） scores ] and the third month [ （90 ± 22 ） scores vs （69 ± 18 ） scores ] after treatment were significantly superior to control group （P 〈 0.05 ）. （3） NIHSS score of treatment group and control group on admission were （ 17.5 ± 3.5 ） scores and （ 16.9 ± 3.4） scores （P 〉 0.05 ）, the NIHSS score of treatment group at the 14th day,the first month and the third month were significantly superior to control group [ （ 14.3 ± 3.3） scores vs （ 16.2 ± 3.5） scores, （ 12.1 ± 2.4） scores vs （ 15.7 ± 3.4） scores, （9.0 ± 3.4 ） scores vs（ 12.2 ± 3.6） scores, respectively] （P〈 0.05）. Conclusion The treatment of severe hypertensive cerebral hemorrhage with minimally invasive pereutaneous is safe and effective, the effect is superior to conventional medical treatment.