改良软通道微创颅内血肿清除术在高血压脑出血治疗中应用

Therapeutic Effect of Soft Channel Minimally Invasive Evacuation of Hematoma for Patients with Hypertensive Intracerebral Hemorrhage

目的:探讨急诊床边行改良-立体定向软通道微创颅内血肿清除术在高血压脑出血中的临床疗效。方法:选取我院35例高血压脑出血患者作为研究对象,在与患者家属沟通并获同意后,随机分成软通微创组15例、硬通微创组10例、开颅减压组10例。治疗判定采用美国国立卫生研究院卒中量表(NIHSS)评分并结合血肿的清除情况,比较3组患者的临床疗效。结果:软通微创组总有效率为93.4%,硬通微创组总有效率为60%,开颅减压组总有效率为50%,统计显示软通微创组的总有效率明显高于硬通微创组和开颅减压组(P<0.05);术后神经功能评分比较,在治疗后第7和14天,软通微创组明显小于硬通微创组和开颅减压组(P<0.05)。结论:急诊床边行改良-立体定向软通微创颅内血肿清除术在高血压脑出血中的治疗具有疗效高、致残率低等优势,值得临床应用与推广。

Objective： To investigate the therapeutic effect of soft channel minimally invasive evacuation of intracranial hematoma in the treatment of patients with hypertensive intracerebral hemorrhage. Method： 35 patients with hypertensive intracerebral hemorrhage who were admitted to our hospital were selected as the research objects. All patients were randomly divided into soft channel group（15 patients, soft channel minimally invasive evacuation of intracranial hematoma） and hard channel group（10 patients, hard channel evacuation of intracranial hematoma） and craniotomy group（10 patients, traditional bone flap craniotomy for evacuation of intracranial hematoma）. NIHSS score and hematoma clearance were compared among the three groups. Result： After treatment, the total treatment effective rates of soft channel group, hard channel group and craniotomy group were respectively 93.4%, 60 % and 50%, and soft channel group was significantly superior to other two groups（P0.05）. NIHSS score of was significantly lower than hard channel group and craniotomy group at 7 and 14 days after treatment. Conclusion： The soft channel minimally invasive evacuation of intracranial hematoma, which can improve the total treatment effective rate and reduce NIHSS score, should get clinical application and promotion.