两种手术方式治疗高血压脑出血的临床比较研究

A study of clinical comparison of two surgical procedures in the treatment of hypertensive cerebral hemorrhage

目的比较高血压引发的脑出血的两种手术方法的治疗效果,为临床治疗提供依据。方法将212例高血压脑出血患者分为开颅组与YL-1型一次性穿刺针穿刺组,根据术前出血部位、血肿量、CT扫描及意识状况分别采取骨瓣开颅血肿清除术和YL-1颅内穿刺术,观察术后24h FAM、ADL评分,了解患者预后情况。结果 YL-1颅内穿刺组术后24h FAM评分、ADL比例明显高于延后开颅组(P<0.05);YL-1颅内穿刺组死亡3/102(2.94%),早期开颅组术后死亡12/58(20.68%),延后术后死亡16/52(30.76%),死亡率,早期组与延后组均高于YL-1颅内穿刺组(P<0.05)。结论早期进行微创YL-1颅内穿刺手术治疗能有效治疗高血压脑出血患者。

Objective To compare and discuss the curative effect of two surgical procedures in the treatment of hypertensive cerebral hemorrhage so as to provide proofs for clinical treatment. Methods 212 patients with hypertensive cerebral hemorrhage were allocated to craniotomy group and YL-1 disposable needle puncture group. The two groups received craniotomy accompanied by cranioplasty and YL-1 intracranial puncture respectively based on bleeding positions, volume of hematoma, CT scanning results and consciousness before the surgery. Postoperative 24-hour FAM and ADL scores were observed and patients’prognosis was acquired. Results Postoperative 24-hour FAM scores and ADL proportion in the YL-1 intracranial puncture group were both significantly higher than those in the postponed craniotomy group（P〈0.05）;death cases of the YL-1 intracranial puncture group were 3/102 （2.94%）, death cases of early craniotomy group were 12/58（20.68%）, and death cases of postponed craniotomy group were 16/52（30.76%）. The mortality rate in the early and postponed groups were all higher than that in the YL-1 intracranial puncture group（P〈0.05）. Conclusion Early operation of minimally invasive YL-1 intracranial puncture is effective in treating patients with hypertensive cerebral hemorrhage.