微创穿刺引流术治疗轻型高血压脑出血与保守治疗疗效的比较

Minimally Invasive Puncture Drainage and Conservative Treatment on Mild Hypertensive Cerebral Hemorrhage

目的评价微创穿刺引流术与保守治疗轻型高血压脑出血的疗效。方法将2007-01-2013-12间我科收治的68例轻型高血压脑出血患者,按治疗方式分为微创穿刺组（33例）与保守治疗组（35例）。对两组患者治疗前后分别进行神经功能缺失评分（NDS）、日常生活能力评定（ADL）及疗效评价。结果微创穿刺组术后1 d、7 d、14 d、28 d NDS减少明显优于保守治疗组,差异有统计学意义（P〈0.05）;治疗28 d后微创穿刺组ADL达良好者（Barthel指数95-100分）14例（42.42%）,保守治疗组为3例（8.57%）,微创穿刺组优于保守治疗组,差异有统计学意义（P〈0.05）;微创穿刺组显效率84.85%,有效率93.94%,保守治疗组显效率54.29%,有效率80.00%,微创穿刺组显效率和有效率明显高于保守治疗组,两者比较差异有统计学意义（P〈0.05）。结论与保守治疗相比,微创穿刺引流术能有效、快速地清除颅内血肿,明显促进患者术后神经功能的恢复,是治疗轻型高血压脑出血的一种有效方法。

Objective To evaluate the different effects of minimally invasive puncture drainage and conservative treatment on mild hypertensive cerebral hemorrhage. Methods The clinical data of 68 patients with mild hypertensive cerebral hemorrhage was analyzed retrospectively,which were divided into two groups： the conservative therapy group（ n = 35） was treated conservatively,the minimally invasive group（ n = 33） was treated with minimally invasive puncture drainage. The neurological deficit score and activities of daily living of two groups were assessed and evaluated before and after treatment. Results After 1 day,7 days＇,14 days＇ and 28 days＇ treatment,the neurological deficit score and activities of daily living of patients were all significantly improved（ P〈0. 05）. 14 cases reached good in ADL after28 d treatment（ 42. 42%）,3 cases in the conservative group（ 8. 57%）,the minimally invasive group was superior to the conservative group,and there was statistical significance（ P〈0. 05）. The significant effective rate and effective rate in the minimally invasive group were84. 85% and 93. 94%. And the significant effective rate and effective rate in the conservative group were 54. 29% and 80. 00%. The significant effective and effective rate were significantly higher than the conservative group,with statistical significance（ P〈0. 05）.Conclusion Compared with conservative treatment,the minimally invasive puncture drainage can efficiently and rapidly remove the intracranial hematoma. It is an effective method for the treatment of mild hypertensive cerebral hemorrhage.