锥颅穿刺术治疗中重度高血压脑出血48例临床分析

Clinical analysis of 48 cases with craniopuncture treatment of severe hypertensive cerebral hemorrhage

目的:探讨在中重度高血压脑出血患者中应用锥颅穿刺术的临床效果及安全性.方法:选取2011/2013我院接治的48例中重度高血压脑出血患者作为本次研究的对象,并以随机数字表法原则将其分成两组,每组24例,将其中实施传统小骨窗开颅血肿清除术治疗者归为对照组,将实施微创锥颅穿刺术治疗者归为观察组.比较并评估两组病例的临床治疗结局,主要包括临床疗效、手术时间、拔管时间、住院天数以及格拉斯哥预后评分量表(GOS)等指标,总结临床治疗经验.结果:观察组治疗后可取得83.3%的临床疗效,较之对照组的58.3%更为理想,比较差异明显(P<0.05);并且观察组在手术时间、拔管时间以及住院天数等方面,要较对照组有优越性(P<0.05).在GOS评分方面,观察组术后的GOS分值是(13.74±3.25)分,要较其术前的(8.47±1.69)分和对照组的(11.02±4.79)分更为理想,比较差异明显(P<0.05).结论:为中重度高血压脑出血患者实施微创锥颅穿刺术治疗有确切效果,并且利于缩短手术时间及住院时间,短期预后效果更好,适合在今后的临床上普及应用.

AIM：To investigate the clinical efficacy and safety in patients with severe hypertensive cerebral hemorrhage treated with craniopuncture.METHODS：48 cases with severe hyper-tensive cerebral hemorrhage were selected as the object of this study from 2011 to 2013,who were divided into two groups ran-domly with 24 cases each group.And the patients with traditional keyhole approach treatment were classified as the control group, while other patients who received the minimally invasive treatment of craniopuncture were classified as observation group.The clini-cal outcomes of two groups of patients were ompared and evalua-ted,including clinical efficacy,operation time,extubation time, hospital stays,Glasgow Outcome Rating Scale （GOS）and other indicators.Clinical experience were summarized.RESULTS：After treatment,the clinical efficacy could reach 83.3%,which was better than that in control group （58.3%）,and the differ-ences was significant （P 〈0.05 ）;Operative time,extubation time and hospital stays of observation group were more superior to that in control group （P 〈0.05）.GOS score in the observation group after treatment was （13.74 ＆#177;3.25）points,which was bet-ter than that of their preoperative （8.47 ＆#177;1.69）and that of con-trol group （11.02 ＆#177;4.79）.Differences were significant （P 〈0.05）.CONCLUSION：The minimally invasive treatment of craniopuncture in treatment of patients with severe hypertension cerebral hemorrhage has better effects,which could shorten the operation time and hospital stays,and has better short-term prog-nosis.It＆#39;s good for universal application in future clinical.