微创血肿穿刺清除术治疗急性脑出血临床效果分析

Clinical Efficacy Analysis of Minimally Invasive Hematoma Puncture Removal for Acute Cerebral Hemorrhage

目的探讨微创血肿穿刺清除术治疗急性脑出血临床疗效。方法研究对象为方便选取该院2016年4月—2017年6月收治急性脑出血患者100例,以随机数字表法分为对照组(50例)和观察组(50例),分别采用小骨窗开颅术和微创血肿穿刺清除术治疗;比较两组患者围手术期临床指标、近期疗效及治疗前后NIHSS评分。结果对照组患者手术用时、术中失血量及住院用时分别为(2.94±0.80)h,(135.26±29.35)m L,(23.20±3.55)d;观察组患者手术用时、术中失血量及住院用时分别为(1.56±0.47)h,(54.87±6.15)m L,(11.76±1.61)d;观察组患者围手术期临床指标水平显著优于对照组(t=3.07,3.44,3.19,P=0.00,0.00,0.00);对照组和观察组患者优良率分别为46.00%,68.00%;观察组患者近期疗效显著优于对照组(χ~2=9.12,P=0.02);同时观察组患者治疗后NIHSS评分显著低于对照组、治疗前(t=3.46,3.17,P=0.00,0.00,P<0.05)。结论微创血肿穿刺清除术治疗急性脑出血可有效减轻医源性创伤,加快术后康复进程,且有助于保护神经功能,价值优于小骨窗开颅术。

Objective This paper tries to investigate the clinical effects of minimally invasive hematoma puncture removal operation in the treatment of acute cerebral hemorrhage. Methods 100 patients with acute cerebral hemorrhage were chosen conveniently in the period from April 2016 to June 2017 in the hospital and randomly divided into both group including control group（50 patients） with small bone window craniotomy and observation group（50 patients） with minimally invasive hematoma puncture removal operation; and the perioperative clinical indicators, clinical efficacy for short-term and NIHSS scores before and after treatment of both groups were compared. Results In the control group, the time of operation, intraoperative blood loss, and hospitalization were（2.94±0.80）h,（135.26±29.35）m L,（23.20±3.55）days. The surgical time, intraoperative blood loss, and hospitalization time of the observation group were respectively. It was（1.56±0.47）h,（54.87±6.15）m L,（11.76±1.61）days. The perioperative clinical indicators in the observation group were significantly better than those in the control group（t=3.07, 3.44, 3.19, P=0.00, 0.00, 0.00）; The excellent and good rates in the control and observation groups were 46.00% and 68.00%, respectively; the short-term efficacy of the observation group was significantly better than that of the control group（χ^2=9.12, P=0.02）; meanwhile, the NIHSS score was significantly lower in the observation group after treatment. In the control group, before treatment（t=3.46, 3.17, P=0.00, 0.00, P〈0.05）. Conclusion Minimally invasive hematoma puncture and debridement for the treatment of acute cerebral hemorrhage can effectively reduce the iatrogenic trauma,speed up the postoperative recovery process, and help to protect the nerve function, the value is better than the the small bone craniotomy.