老年脑出血患者血肿穿刺粉碎术疗效分析

Therapeutic effect of intracranial hematoma smash puncture on the aged patient with cerebral hemorrhage

目的 分析老年脑出血患者采用颅内血肿穿刺粉碎术治疗的疗效。方法 对 3年内收治的脑出血患者 1 0 4例 ,按老年与非老年并分别按穿刺与常规内科治疗分组 ,对照分析临床疗效。结果 老年穿刺组 36例与非老年穿刺组 2 1例比较 ,穿刺后再出血发生率 (0 /36 ,2 /2 1 )相差显著 ;老年穿刺组 36例与老年常规治疗组 33例比较 ,近期死亡率 (1 6 .6 7% ,39.40 % ,P <0 .0 5 ) ,ADL1～2率 (5 8.6 2 % ,5 .88% ,P <0 .0 0 5 )及ADL 4～ 5率 (1 3.79% ,47.0 6 % ,P <0 .0 2 5 )相差显著。结论 颅内血肿穿刺粉碎术治疗老年脑出血患者安全有效 ,特别有利于减低致残率。

Objective To analyze the advantages of intracranial hematoma smash puncture (IHSP) in the treatment of cranial hemorrhage for the elderly. Methods A total of 104 cases of cerebral hemorrhage admitted in the recent 3 years were collected and divided into 4 groups, i.e. group A, elderly with IHSP treatment ( n =36), group B, elderly with regular medical treatment ( n =33), group C, non elderly with IHSP treatment ( n =21) and group D, non elderly with routine therapy ( n =14). The clinical and follow up outcomes were studied and analyzed. Results There was significant difference in rehemorrhage rate after puncture between group A (0/36) and group C (2/21). Significant difference was found in early mortality rate in group A (16.67%) and group B (39.40%). The rate of activity of daily living (ADL) 1-2 was significantly higher in group A (58.62%) than group B (5.88%)( P <0.005) and that of ADL 4-5 was obvious lower in group A (13.79%) than group B (47.06%)( P <0.025). Conclusion Intracranial hematoma smash hemorrage is safe and efficient in the treatment of elderly cerebral hemorrhage, especially in reducing the disability rate.