颅内血肿微创引流术首次血肿抽吸率的探讨

An analysis about the initial clearance rate in minimally invasive procedures for intracerebral he- matoma evacuation

目的探讨脑出血颅内血肿微创穿刺引流术首次血肿抽吸率。方法回顾性分析2008-01—2015—09钻孔血肿外引流术的自发性脑出血病例资料88例，根据血肿首次抽吸率将患者分为三组，比较三组间单位时间内术后残余血肿清除率、水肿体积、NIHSS评分及术后再出血率。结果三组患者术后第3、7、14天残余血肿清除率、水肿体积及NIHSS评分差异均有统计学意义（P〈0．00），首次血肿抽吸率、NIHSS评分与残余血肿清除率及水肿变化具有相关关系（P〈0．00）。三组间术后再出血率差异元统计学意义。结论颅内血肿微创穿刺引流术首次血肿抽吸率对残余血肿的液化引流、血肿周围水肿体积及神经功能的恢复均有影响；首次血肿抽吸率高者残余血肿清除率也较高，血肿周围水肿体积增加较少，甚至水肿体积减小，神经功能恢复也快；对于首次血肿抽吸率在60％以下的患者，首次抽吸率越高，术后恢复越快。

Objective To analyze the best initial clearance rate in minimally invasive proce- dures for intracerebral hematoma evacuation. Methods A total of 88 patients who underwent minimally invasive treatment during January 2008 to September 2015 were divided into 3 groups according to their first clearance rate, the residual hematoma absorption rate, edema volume, NIHSS score and rehleeding rate were compared. Results The difference of the residual hematoma absorption rate, edema volume and NIHSS score in 3 groups were statistically significant on 3,7,14 days after the surgery （P 〈 0.00）. The first clearance rat and NIHSS score had relations to the residual hematoma absorption rate and ede- ma volume. The difference of rebleeding rate had no statistical significance. Conclusion Minimally in- vasive procedures for intracerebral hematoma evacuation have effect on the residual hematoma absorp- tion rate, edema volume and neural function. High hematoma clearance rate leads to high residual hema- toma absorption rate, low edma volume and fast neural function recovery. In patients with first clearance rate below 60%, the higher initial clearance rate leads to better recovery.