微创穿刺术治疗中等量高血压脑出血的疗效分析

Therapeutic analysis of minimally invasive craniopuncture on patients with moderate hypertensive cerebral hemorrhage

目的评价微创穿刺清除术与传统保守治疗中等量基底节区高血压脑出血的效果。方法回顾性分析 84 例中等量(30～60 ml)高血压基底节区脑出血患者临床资料,分为微创穿刺血肿清除术(微创组,45 例)和传统保守治疗(保守组 39 例),评价两组患者 1 周时的意识恢复情况、治疗 1 个月时神经功能缺损程度(NID)和 3 个月时日常生活活动能力(ADL)。结果治疗第 7 天时微创组的意识恢复率(75.6%)明显高于保守组(46.0%);1 个月后微创组患者的 NID明显低于保守组(P<0.05);治疗 3 个月后随访,患者 ADL 达自理水平的较好状态者(Barthel 指数≥80),两组有显著性差异(P<0.05),微创组优于保守组。结论与保守组相比,微创穿刺术可明显改善中等量基底节区脑出血患者早期的意识状况,改善神经功能缺失程度、提高患者日常生活活动能力,降低病残率。

Objective To evaluate the curative effect of minimally invasive craniopuncture therapy and traditional conservative treatment on patients with moderate hypertensive cerebral hemorrhage. Methods The clinical data of 84 patients with moderate hypertensive basal ganglia hemorrhage （30-60 ml） were retrospectively analyzed. In all patients, 45 cases underwent minimally invasive hematoma removal surgery（minimally invasive group）,39 cases maintained traditional conservative treatment （conservative group）. Conscious recovery of patients, neurologic deficit （NID） and the activities of daily living （ADL） were evaluated at 1 week, 1 month, 3 months, respectively. Results The consciousness recovery rate of the minimally invasive group（75.6%）on 7th day was significantly higher than that conservative group（46.0%）. NID in minimally invasive group was significantly lower than that conservative group （P0.05）. The scores of ADL （by Barthel Index） in minimally invasive group were also higher than that conservative group 3 months after the follow-up （P0.05）. Conclusion Compared with the conservative treatmemt, minimally invasive surgery could significantly improve early consciousness, neurological deficits and increase activities of daily living in patients with hypertensive basal ganglia hemorrhage.