高血压脑出血微创和保守治疗的对比研究

Comparative Study of Minimally Invasive Surgery and Conservative Treatment for Hypertensive Cerebral Hemorrhage

目的对比高血压脑出血微创手术治疗和保守治疗的临床疗效,为临床治疗策略的制定提供参考。方法选取泸县人民医院神经内科收治的167例高血压脑出血患者,根据治疗方案的不同将其分为微创治疗组113例和保守治疗组54例。微创治疗组采用微创颅内血肿清除术进行治疗,保守治疗组采用常规内科保守治疗。治疗3个月后,对比两组患者的意识恢复时间和临床治疗效果。结果经过治疗后,微创治疗组的意识恢复时间为(3.01±0.59)d,显著少于保守治疗组(P<0.05)。微创治疗组的治愈率为28.32%,显效率为39.82%,总有效率为86.73%,均显著高于保守治疗组(均P<0.05);微创治疗组的无效率为7.96%,死亡率为5.31%,均显著低于保守治疗组(均P<0.05)。结论微创颅内血肿清除术治疗高血压脑出血,可早期清除血肿,控制病情,能够有效提高本病的临床疗效,改善患者的预后,值得在临床进一步推广。

Objective To compare the clinical effect of minimally invasive operation treatment and conservative treatment for patients with hypertensive cerebral hemorrhage, in order to provide the reference for clinical therapeutic strategies. Methods 167 patients with hy- pertensive cerebral hemorrhage were selected from the Department of Internal Medicine, Lu County people＇s Hospital. According to the dif- ferent treatments, the patients were divided into the minimally invasive treatment group with 113 cases and conservative treatment group with 54 cases. Minimally invasive treatment group were treated by minimally invasive evacuation of intracranial hematoma for treatment, and the conservative treatment group with conventional internal medicine. After 3 months of treatment, the consciousness recovery time and the clin- ical therapeutic effects of the two groups were compared. Results After the treatment, the consciousness recovery time of the minimally in- vasive treatment group was （ 3. O1 ＋ 0. 59 ） days, which was significantly less than the conservative treatment group （ P 〈 O. 05 ）. In the minimally invasive treatment group, the cure rate was 28.32%. The effective rate was 39. 82%, and the total effective rate was 86. 73%, which were significantly higher than the conservative treatment group （ P 〈 0. 05 ）. The inefficiency of the minimally invasive treatment group was 7.96%, and mortality was 5.31%, which were significantly lower than the conservative treatment group （ P 〈 0. 05 ）. Conclusion Minimally invasive treatment of intracranial hematoma in hypertensive cerebral hemorrhage can help for early clearance of hematoma and disease control. It can effectively improve the clinical efficacy of the disease, improve the prognosis of patients, and is worthy of further clinical application.