CT监视下定向硬通道技术治疗老年高血压脑出血的疗效分析

CT-monitored hard-directional channel technology in treatment of elderly patients with hypertensive intracerebral hemorrhage

目的探讨CT监视下定向硬通道技术及开颅手术治疗3～5级老年高血压脑出血(HICH)患者的疗效差别。方法回顾性分析我科治疗的94例老年HICH患者,按手术方式分开颅手术组(50例)及微创手术组(44例),比较两组患者死亡率及重度残疾率的差别。结果开颅手术组死亡率为44%,微创手术组死亡率为32%,两组无显著统计学差异(P>0.05);应用ADL分级法评价患者预后,Ⅳ级及V级植物生存状态为重度残疾,开颅手术组重度残疾率为50%,微创手术组重度残疾率为23%,两者有显著的统计学差异(P<0.05)。结论 CT监视下定向硬通道技术是简便、有效的方法,可改善3～5级老年高血压脑出血患者的预后。

Objective To compare the therapeutic effects difference of CT-monitored hard-directional channel technology and classical craniotomy method for elderly patients with hypertensive intracerebral hemorrhage classified as grade 3 to 5.Methods A retrospective analysis was conducted in 94 elderly patients with hypertensive intracerebral hemorrhage.According to operation mode, they were classified as craniotomy group（n=50） and mini-invasive operation group（n=44）.The mortality rate and heavy deformity rate were compared between the two groups by chi square test.Results There was no significant difference in mortality rate between mini-invasive operation group and craniotomy group（32%vs 44%,P0.05）.Activities of daily living（ADL） scale was used to assess the prognosis of the patients,and heavy deformity was defined as the fourth stage or the fifth stage assessed by ADL scale. There was significant difference in heavy deformity rate between mini-invasive operation group and craniotomy group（23%vs 50%, P0.05）.Conclusion CT-monitored hard-directional channel technology can improve the prognosis of elderly patients with hypertensive intracerebral hemorrhage classified as grade 3 to 5,and this minimally invasive technique is convenient and effective.