微创血肿引流术对高血压脑出血患者神经功能恢复的影响机制研究

Nerve function recovery mechanism of minimally invasive drainage of the hematoma in patients with hypertensive cerebral hemorrhage

目的探讨微创血肿引流术对高血压脑出血患者神经功能恢复的影响机制研究。方法将40例高血压脑出血患者按照随机数字表法分为常规治疗组和微创血肿引流术组,每组各20例。分别于治疗后第21天时采用斯堪的纳维亚卒中量表评分(scandinavian stroke scale,SSS)评分以及治疗后第90天时采用改良Rankin量表(modified Rankinscale,MRS)评分及Barthel指数(barthel iondex,BI)评分、日常生活能力(ADL)评分进行比较两组神经功能恢复情况。结果观察组术后第21天的SSS评分较对照组升高更显著(P<0.05)。观察组术后第90天的MRS评分较对照组降低更明显(P<0.05)。观察组术后第90天的BI评分较对照组提高更显著(P<0.05)。术后随访6个月,观察组20例患者术后死亡1例,存活19例,ADL 1级患者所占比率达52.63%,明显高于对照组(35.71%),差异有统计学意义。结论微创血肿引流术有助于高血压脑出血患者神经功能的恢复,提高日常生活自理能力,是提高预后生存质量的有效治疗方法之一,值得推广和应用。

Objective To investigate the nerve function recovery mechanism of minimally invasive drainage of the hematoma in patients with hypertensive intracerebral hemorrhage. Methods All 40 patients with hypertensive cerebral hemorrhage were randomly divided in accordance with conventional treatment group and the minimally invasive hematoma drainage group, 20 patients in each group respectively. After treatment 21 days, used the Scandinavian Stroke Scale Score（scandina- vian stroke scale, SSS） score and after treatment 90 days used the modified Rankin Scale （Modified Rankin scale,MRS） score and Barthel Index （barthel iondex, BI） score, Activities of Daily Living （ADL） score to compare two sets of recovery of neurological function. Results The first 21 days after the SSS score than the control group increased more significantly （P 〈 0.05）. Observation group after 90 days of MRS score decreased more significantly than the control group （P 〈 0.05）. Observa- tion group after 90 days of BI score than the control group increased more significantly（P 〈 0.05）. Patients were followed up for 6 months, 20 patients were observed after 1 died,survived 19 cases, ADL1 level percentage of 52.63% of patients, significantly higher（35.71%）, the difference was statistically significance. Conclusion Minimally invasive surgery to help drain the hematoma in patients with hypertensive cerebral hemorrhage recovery of neurological function and improve the ability of daily living, is effective treatment methods for imporing quality of life and the prognosis, should be promoted and applied.