微创穿刺血肿引流术对老年高血压脑出血患者抑郁的影响研究

Effects of Minimally Invasive Puncture and Drainage on Depression in Senile Patients with Brain Hemorrhage due to Hypertension

目的探讨微创穿刺血肿引流术对老年高血压脑出血患者抑郁症状的影响。方法将2013年5月至2015年4月期间收治的、符合入组标准的164例老年高血压脑出血患者随机分成两组,对照组(82例)采用传统开颅血肿清除术治疗,研究组(82例)采用微创穿刺血肿引流术治疗。采用汉密尔顿抑郁量表(HAMD-17)评估患者术前以及术后30天和90天的抑郁程度;采用美国国立卫生研究院卒中量表(NIHSS)评估患者的神经功能。结果术前两组患者HAMD和NIHSS评分相似(P>0.05);术后30天和90天时研究组患者的HAMD评分和卒中后抑郁发生率显著低于对照组,其NIHSS评分也显著优于对照组(P<0.01)。结论相对于传统开颅血肿清除术,微创穿刺血肿引流术可更加有效抑制老年高血压脑出血患者的抑郁和恢复其神经功能,因而具有良好的应用前景。

Objective To investigate the effects of minimally invasive puncture and drainage on depressive symptoms in senile patients with brain hemorrhage due to hypertension. Methods One hundred and sixty-four qualified senile patients with brain hemorrhage due to hypertension,who began their hospitalization from May,2013 to April,2014,were divided randomly into control group（ 82 cases） and research group（ 82 cases）. The patients in the control group were operated with traditional craniotomy for removal of hematoma,whereas the patients in the research group were operated with minimally invasive puncture and drainage. Before the operation and at30 days and90 days after the operation,the depression state and neurological function of the patients were evaluated with HAMD-17 and National Institutes of Health Stroke Scale（ NIHSS）,respectively. Results Before the operation,the two groups were similar with respect to HAMD and NIHSS scores（ P〉0. 05）; after 30 days and 90 days of treatment,the HAMD scores and post-stroked depression（ PSD） rate of the research group were significantly lower than that of the control group（ P〈0. 01）,and the NIHSS scores of the research group were also significantly better than that of the control group（ P〈0. 01）. Conclusion Compared with traditional craniotomy,minimally invasive puncture and drainage vs. traditional craniotomy for removal of hematoma has more excellent effects in inhibiting depression emotion and restoring nerve function; thus,it has a promising prospect for treating senile patients with brain hemorrhage due to hypertention.