微创定向置软管治疗重症高血压性脑出血的方法及临床效果分析

Clinical Effects of Minimally Invasive Directed Tube Set on Severe Hypertensive Cerebral Hemorrhage

目的探讨微创定向置软管引流术救治重症高血压性脑出血的方法、临床效果及意义。方法回顾分析近3年来在我科住院的重症高血压性脑出血患者106例,其中内科保守治疗44例(保守治疗组),微创治疗62例(微创治疗组),比较两组患者的近期(1个月)和远期(6个月)治疗效果。结果治疗后1个月,微创治疗组62例患者中优11例,良21例,重度病残16例,植物生存状态0例,死亡14例;内科保守治疗组44例患者中优2例,良5例,重度病残10例,植物生存状态2例,死亡25例;两组患者的近期疗效间差异有统计学意义(u=4.213,P<0.01)。治疗后6个月,微创治疗组48例患者中失访4例,治愈7例,良好27例,病残6例,死亡4例;内科保守治疗组19例患者中失访3例,治愈3例,良好4例,病残7例,死亡2例,两组患者的远期疗效间差异有统计学意义(u=2.145,P<0.05)。结论与内科保守治疗相比,微创定向置软管引流术能明显改善重症高血压性脑出血患者的神经功能缺损,提高患者日常生活能力,并显著降低了患者的病死率。

Objective To explore the methods of minimally invasive directed tube set in treatment of severe hypertensive cerebral hemorrhage and its clinical effects and significance. Methods Clinical data of 106 patients with severe hypertensive cerebral hemorrhage admitted to our department in recent 3 years were analyzed retrospectively.The patients were divided into groups A（n=44,receiving conservative medical treatment） and B（n=62,receiving minimally invasive treatment）.Short-term（1 month） and long-term（6 months） treatment effects were observed. Results One month after treatment,in 62 patients of group B,11 had excellent treatment effectiveness,21good,16 severe disability,0 in vegetative survival state and 14 died;in 44 of group A,2,5,10,2,25,respectively;the difference was significant（u=4.213,P0.01）.After 6 months,in 48 patients of group B,4 were lost to follow-up,7 cured,27 had good effectiveness,6 disability,4 died;in 19 of group A,3,3,4,7,2,respectively;the difference was significant（u=2.145,P0.05）. Conclusion Compared with conservative treatment,minimally invasive directed tube set can improve obviously the neurological deficit of severe hypertensive cerebral hemorrhage and patients′ daily living ability and reduce remarkably mortality.