少量高血压脑出血微创手术与保守治疗疗效对比研究

Contrastive Analysis of Clinical Efficacy on Hypertensive Intracerebral Hemorrhage Patients with the Small Amount of Hematomas between Minimally Invasive Surgery and Conservative Treatment

目的比较微创血肿清除术与保守治疗少量血肿(<30 m L)的高血压脑出血患者临床疗效.方法将临床确诊为颅内深部少量出血的96例高血压患者作为研究对象.将所有研究对象随机分为两组:微创手术治疗组(微创组)(50例患者)和保守治疗组(对照组)(46例患者).微创组采用微创穿刺血肿清除术对高血压脑出血患者颅内血肿进行微创穿刺清除,对照组给以常规药物保守治疗.通过检测神经功能缺损评分、Glasgow昏迷评分、死亡率、再出血率、平均住院时间和格拉斯哥预后(GOS)评分情况,对两组患者的临床疗效和短期预后进行对比分析.结果 1)神经功能缺损评分结果显示:微创组患者神经功能恢复程度显著优于对照组,两组数据比较差异显著,具有统计学意义(P<0.05).2)患者入院1周后Glasgow昏迷评分(GCS)检测结果显示:微创组明显好于对照组,两组数据比较差异显著,具有统计学意义(P<0.05).3)微创组再出血的发生率较对照组相比有增高的趋势(P<0.05),死亡率两组数据比较无显著统计学意义(P>0.05).4)微创组患者平均住院时间要短于对照组(P<0.05).5)采用格拉斯哥预后(GOS)评分系统对出院半年后患者的生存质量进行评估,结果显示微创组GOS得分情况明显高于对照组,两组数据比较差异显著,具有统计学意义(P<0.05).结论 1)微创手术治疗能明显改善少量血肿的高血压脑出血患者意识状态和神经功能障碍,促进功能恢复,缩短患者平均住院时间,患者的短期预后和恢复效果明显.2)微创血肿清除术能显著缩短少量血肿的高血压脑出血患者住院时间,减少患者住院费用,有助于缓解患者经济负担.

Objective To study the clinical efficacy of minimally invasive surgery on hypertensive intracerebral hemorrhage patients with the small amount of hematomas by comparing with the conservative treatment. Method A total of 96 hypertensive intracerebral hemorrhage patients with the small amount of hematomas were recruited. 96 patients were randomly divided into two groups ： minimally invasive surgery group （ treatment group） and conservative treatment group （control group）. There were 40 patients in treatment group and 46 patients in control group. Clinical curative effects were comparatively studied in these two groups. Minimally invasive group using minimally invasive puncture for removal of hematoma in patients with hypertensive intracerebral hemorrhage;control group were only given routine medicine conservative treatment. Through the detection of neural function defect scale, Glasgow coma scale, the average length of hospital stay, mortality, and bleeding rate and Glasgow outcome （ GOS ） score of two groups of patients with the clinical curative effect and short-term prognosis were analyzed. Results 1 ） The neural function defect scale in the treatment group was superior to that in the control group. There were statistically significant differences between the two groups （P〈0.05）. 2 ） The Glasgow coma scale of patients in treatment group at 1 week after admission was superior to that in the control group. There were statistically significant differences between the two groups （P〈0.05）. 3 ）The incidence of rebleeding in the treatment group presented a growth trend compared to the control group （ P〈0.05 ）. There were no significant difference in the mortality rate between the two groups （ P〉0.05 ）. 4 ） The length of hospital stay in the treatment group was obviously shorter than that in the control group （ P〈0.05 ）. 5 ） The Glasgow prognostic score of patients in the treatment group, who had discharged from hospital for six months, was significantly higher than that in the control group （ P 〈 0. 05 ）. Conclusion 1 ） Minimally invasive treatment of hypertensive intracerebral hemorrhage patients with the small amount of hematomas can significantly improve the consciousness and neural dysfunction, facilitate the patients＇ recovery, shorten the average length of hospital stay, and could improve the long-term prognosis and recovery of patients. 2） Minimally invasive surgery can significantly reduce the amount of hematoma in hypertensive cerebral hemorrhage patients during the hospitalization, reduce the cost of hospitalization, and help to alleviate the economic burden of the patients.