高血压脑出血并发脑疝患者的微创减压效果研究

Effect of minimally invasive decompression in patients with hypertensive cerebral hemorrhage complicated with cerebra hernia

目的探究高血压脑出血并发脑疝患者运用微创减压的治疗效果。方法选取2015年7月～2016年6月于我院进行治疗的64例高血压脑出血并发脑疝患者作为研究对象,所有患者均进行颅脑CT等相关检查方法,采取吸氧、脱水等常规治疗手段。对照组患者在此基础上采取去骨瓣减压术治疗方案。观察组患者则进行微创穿刺引流术,然后进行开颅操作进行血肿清除以及去骨瓣减压术等。记录患者术后住院时间、血肿完全吸收的时间以及术后并发症发生的情况。术后对患者进行为期半年的随访,采用GOS评分和健康相关生活质量量表对术后6个月患者的生活质量进行评分比较。结果两组患者住院时间分别为(12.5±5.4)d和(9.3±4.7)d(P <0.05)。对患者随访半年,对照组患者良好率为28.1%,观察组患者良好率为53.1%(P <0.05)。两组患者生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感功能、精神健康等方面评分差异有统计学意义(P <0.05)。结论微创穿刺引流术能够改善高血压脑出血并发脑疝患者的手术效果,但运用微创穿刺引流术配合去骨瓣减压术的患者术后以及远期治疗效果均优于单独运用去骨瓣减压术的患者,提高其术后恢复情况和生活质量。

Objective To explore the treatment effect of minimally invasive decompression in patients with hypertensive cerebral hemorrhage complicated with cerebral hernia. Methods Sixty-four cases of hypertensive cerebral hemorrhage complicated with cerebral herniainhospital from July 2015 to June 2016 were selected as the study subjects.All patients were examined by craniocerebral CT and given routine treatment such as oxygen inhalation and dehydration.On this basis,the patients in the control group were givenecompressive decompression.The patients in the observation group were treated with minimally invasive decompression and drainage,followed by craniotomy for hematoma clearance and decompression of bone flaps.The hospitalization time,the time of complete absorption of hematoma and the occurrence of complications were recorded.The patients were followed up for a period of six months.Postoperative patients were followed up for half a year.Six months after surgery,patients’ quality of life between the two groups were compared with GOS score and health-related quality of life scale. Results The hospitalization time of the two groups were(12.5+5.4)d and(9.3+4.7)d(P < 0.05).Following up for half a year,the good rate of the control group was 28.1%,and that of the observation group was 53.1%(P < 0.05).The scores of physiological function,physiology function,physical pain,overall health,vitality,social function,affective function and mental health were statistically significant(P < 0.05). Conclusion minimally invasive decompressionand drainage can improve the surgical effect of patients with hypertensive cerebral hemorrhage complicated with cerebral hernia, but the use of minimally invasive decompressionand drainage combined with decompressive craniectomy is superior to the use of decompressive craniectomy alone in the post-operative and long-term outcomes.That can improve the postoperative recovery and quality of life.