颅内血肿微创清除术治疗小量高血压性壳核出血疗效观察

Effect of minimally invasive procedure for removal of intracranial hematoma on small hypertensive intracerebral hemorrhage in putamen

目的探讨颅内血肿微创清除术治疗小量高血压性壳核出血的疗效,为临床治疗小量高血压性壳核出血提供参考。方法选择住院治疗的80例小量高血压性壳核出血患者,根据治疗方法不同分为对照组和观察组各40例。对照组采用常规内科保守治疗,观察组在内科保守治疗的基础上接受颅内血肿微创清除术。分别于治疗后第1天、第1周、第2周及第3周测量2组患者颅内剩余血肿量、血肿周围水肿量并进行神经功能缺损程度评分,并对测量值及评分结果进行比较。治疗后第3周2组患者进行显效率比较。治疗后3个月2组患者进行日常生活能力比较。结果观察组在治疗后第1天、第1周、第2周、第3周颅内剩余血肿量、血肿周围水肿量均明显少于同时期的对照组,2组差异有统计学意义(P<0.01);观察组在治疗后第1天、第1周、第2周、第3周神经功能缺损评分明显小于同时期的对照组,2组差异有统计学意义(P<0.01);观察组治疗后第3周临床疗效显效率高于对照组,2组差异有统计学意义(P<0.05);观察组治疗后3个月日常生活能力评分好于对照组,2组差异有统计学意义(P<0.05)。结论颅内血肿微创清除术治疗小量高血压性壳核出血,能够较快地清除颅内血肿,减轻颅内水肿,改善神经缺损程度,提高患者的生活质量,其疗效优于内科保守治疗,是比较安全、有效的一种治疗方法。

Objective To explore the effect of minimally invasive procedure for removal of intracranial hematoma in the treatment of small hypertensive intracerebral hemorrhage in putamen. Methods A total of 80 patients with small hypertensive intracerebral hemorrhage in putamen were randomly assigned to observation group（ n = 40） and control group（ n =40）. The control group received the conservative treatment,while the observation group received minimally invasive procedure for removal of intracranial hematoma in addition to the conservative treatment. The remaining hematoma volume and edema volume around the hematoma and efficiency and neurologic impairment score on the first day,the first week,second week and third week,the significant efficiency on third week,and the difference of activity of daily living on third month were compared between the two groups. Results There was significant difference in remaining hematoma volume and edema volume around the hematoma between the two groups on the first day,the first week,second week and third week after treatment（ P〈0. 01）; There was difference in neurologic impairment score between the two groups on the first day,the first week,second week and third week after treatment（ P〈0. 01）; There was significant difference of efficiency between the two groups on the third week after the treatment（ P〈0. 05）; There was significant difference of the cure rate of activity of daily living between the two groups on the third week after the treatment（ P〈0. 05）. Conclusion The minimally invasive procedure for removal of intracranial hematoma can quickly remove the intracranial hematoma,relieve brain edema,improve neurologic impairment,and improve the patient＇s quality of life. The curative effect is superior to the internal medicine conservative treatment,and is a relatively safe and effective treatment for small hypertensive intracerebral hemorrhage in putamen.