手术治疗高血压脑出血并脑疝患者的疗效及预后分析

Analysis of efficacy and prognosis of joint surgery in treatment of hypertensive intracerebral hemorrhage combined with hernia

目的探讨联合手术治疗高血压脑出血并脑疝患者的临床疗效及预后。方法收集2013-12—2014-12接受治疗的高血压脑出血并脑疝患者60例,按照随机数字表法分为观察组与对照组各30例,对照组患者给予常规开颅血肿清除术联合去骨瓣减压治疗,观察组患者在减压前给予微创穿刺引流治疗。采用格拉斯哥转归量表(GOS)评估2组患者预后情况,比较临床疗效。结果观察组预后良好率93.33%,高于对照组的70.00%,2组比较差异有统计学意义(χ2=5.64,P<0.05)。预后良好者ICP为(16.76±3.02)mmHg,预后差者为(26.52±3.90)mmHg,差异有统计学意义(t=8.60,P<0.05)。2组患者GOS评分比较差异有统计学意义(t=5.01、6.84、7.34,P<0.05)。结论联合手术治疗高血压脑出血并脑疝患者可降低相关并发症发生率,提高了临床疗效及预后,值得临床推广。

Objective To investigate the efficacy and prognosis of joint surgery in treatment of hypertensive intracerebral hemorrhage combined with hernia.Methods 60 cases with hypertensive intracerebral hemorrhage combined with hernia were selected during the period from December 2013 to December 2014,they were divided into the observation group and the control group according to the random number table method,30 cases in each group,the patients of the control group were given conventional craniotomy combined decompressive craniectomy,the patients of the observation group were given minimally invasive puncture and drainage on the basis of the control group,the prognosis of two groups was assessed by Glasgow outcome scale（GOS）after treatment,clinical efficacy was compared.Results The rate of good prognosis in the observation group was93.33%,which was higher than 70.00%in the control group,the difference was statistically significant（χ2=5.64,P〈0.05）.ICP in patients with good prognosis was（16.76±3.02）mmHg,ICP of patients with poor prognosis was（26.52±3.90）mmHg,the difference was statistically significant（t=8.60,P〈0.05）.GOS score of two groups had statistically significant（t=5.01,6.84,7.34,6.43,P〈0.05）.Conclusion Joint surgery in treatment of hypertensive intracerebral hemorrhage combined with hernia can reduce related complications,improve clinical outcomes and prognosis,it is worthy of promotion in clinic.