微创颅内血肿清除术治疗高血压脑出血患者的临床疗效

Minimally invasive removal of intracranial hematoma in the treatment of hypertensive cerebral hemorrhage in clinical research

目的探讨微创颅内血肿清除术治疗高血压脑出血患者的临床疗效。方法将2013年8月至2016年8月在梅州市人民医院神经外科治疗的84例高血压脑出血患者按随机数字表法分为两组,对照组患者采用开颅去骨瓣减压血肿清除术,观察组采用微创颅内血肿清除术,术后28 d比较两组患者的治疗效果、手术各项指标、血肿及周围水肿改善情况、术后神经功能及生活质量、预后。结果观察组患者治疗总有效率为95.3%,明显高于对照组的80.5%,差异有统计学意义(P<0.05);观察组患者的手术时间、术中出血量与对照组相比差异显著(P<0.05);观察组患者治疗后血肿量及周围水肿量较对照组明显减少,且神经功能缺损评分(NIESS)及日常生活能力BI指数明显较对照组改善,差异均有统计学意义(均P<0.05);观察组患者术后并发症发生率及死亡率均较对照组明显降低,差异均有统计学意义(均P<0.05)。结论微创颅内血肿清除术治疗高血压脑出血患者临床疗效显著,利于血肿的早期消除及神经功能恢复,对患者预后的改善有积极的临床意义。

Objective To study the minimally invasive removal of intracranial hematoma in the treatment of hypertensive cerebral hemorrhage in clinical research.Methods August 2013-August 2016 in our hospital neurosurgery treatment of 84 patients with hypertensive cerebral hemorrhage were randomly divided into two groups,control group adopts to bone flap craniotomy decompression for removal of hematoma,observation group with minimally invasive removal of intracraniat hematoma,postoperative 28 d compare the treatment effect of two groups of patients,the indicators,the hematoma and the surrounding edema operation,postoperative nerve function and quality of life and prognosis.Results The observation group treatment effective rate was 95.3%,significantly higher than the 80.5% in the control group,the difference was statistically significant（P〈0.05）;Observation group operation time, intraoperative blood loss compared with the control group signifcant difference（P〈0.05）;After treatment the observation group the hematoma volume and the surrounding edema quantity is obviously lower than the control group,the difference was statistically significant（P〈0.05）;After treatment observation group NIESS and BI score was better than control group,the difference was statistically significant（P〈 0.05）;Incidence of complications and mortality of observation group were significantly lower than the control group, the difference was statistically significant（P〈0.05）. Conclusion Minimally invasive removal of intracranial hematoma in the treatment of hypertensive cerebral hemorrhage curative effect significantly, to facilitate early hematoma elimination and neural function recovery, have positive clinical significance on the improvement of the prognosis.