中少量高血压脑出血微创手术治疗的临床疗效分析

Clinical effect of minimally invasive surgical treatment for mild-to-moderate hypertensive cerebral hemorrhage

目的观察并探讨利用微创手术治疗中少量高血压脑出血的临床疗效。方法将110例中少量高血压脑出血患者按治疗方式不同分为两组。微创手术组给予立体定向微创钻孔引流术治疗;保守治疗组给予控制血压、止血、降颅压等保守治疗方法。治疗5天后观察并比较两组患者的血肿清除率,治疗6个月后观察两组患者的日常生活能力量表评分情况。结果微创手术组血肿清除率为100%,对照组的血肿清除率为77.3%,微创手术组血肿清除率明显高于保守治疗组,两组差异有统计学意义(P<0.05);微创手术组患者的日常生活能力量表评分为(73.58±6.01),对照组的患者的日常生活能力量表评分为(61.02±7.23),微创手术组患者的日常生活能力明显高于保守治疗组,两组有差异有统计学意义(P<0.05)。结论微创手术治疗中少量高血压出血不仅近期疗效显著,远期疗效也远远好于保守治疗的方式,值得在临床推广使用。

Objective To investigate the clinical effect of minimally invasive surgical treatment for mild-tomoderate hypertensive cerebral hemorrhage. Methods A total of 110 patients with mild-to-moderate hypertensive cerebral hemorrhage were enrolled and divided into two groups according to the treatment modality. The patients in the minimally invasive surgery group were given minimally invasive stereotactic burr hole drainage, and those in the conservative treatment group were given conservative treatment including blood pressure control, hemostasis, and intracranial pressure lowering treatment. The hematoma clearance rate was observed and compared between the two groups after 5 days of treatment, and the activities of daily living score was observed after 6 months of treatment.Results The minimally invasive surgery group showed a significantly higher hematoma clearance rate than the conservative treatment group（100% vs 77.3%, P〈0.05）. The minimally invasive surgery group also showed a significantly higher activities of daily living score than the conservative treatment group（73.58±6.01 vs 61.02±7.23, P0.05）.Conclusion Compared with conservative treatment, minimally invasive surgery has significantly better short- and long-term effect in the treatment of mild-to-moderate hypertensive cerebral hemorrhage and holds promise for clinical application.