颅内压动态监测下行多靶点穿刺治疗基底节区脑出血的临床效果

Effect of intracranial pressure dynamic monitoring and multi-target puncture in treating basal ganglia intracerebral hemorrhage

目的分析基底节区脑出血病人行颅内压动态监测下多靶点穿刺治疗的效果。方法收集本院神经外科2015年10月至2017年10月收治行手术治疗的基底节区脑出血病人84例作为研究对象,随机分为对照组与试验组,每组42例。对照组实施大骨瓣减压术联合颅骨修补术治疗,试验组实施颅内压动态监测联合多靶点穿刺治疗,分析比较不同术式的疗效差异。结果试验组术后7 d血肿清除率为(98. 20±7. 75)%,对照组为(92. 70±6. 75)%;试验组引流时间为(4. 20±1. 84) d,对照组为(5. 40±1. 36) d; 2组比较,差异均有统计学意义(P<0. 05)。试验组术后格拉斯哥昏迷评分(GCS)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-px)水平均高于对照组,丙二醛(MDA)水平低于对照组(P<0. 05),且术后并发症更少,远期疗效更佳(P<0. 05)。结论动态监测颅内压联合多靶点穿刺治疗基底节区脑出血的近远期疗效显著,具有更高的应用价值。

Objective To analyze the effect of multi-target puncture treatment under dynamic intracranial pressure monitoring in the patients with cerebral hemorrhage in basal ganglia region.Methods Eighty-four patients with basal ganglia intracerebral hemorrhage treated in our hospital from October 2015 to October 2017 were enrolled and were randomly divide into control group and experimental group,with 42 cases in each group. The control group was implemented a big bone flap decompression for the treatment of bone repair,and the experimental group was given multi-target puncture treatment under dynamic intracranial pressure monitoring. The clinical therapeutic effects were observed and compared between the two groups. Results The hematoma clearance rate and the drainage time was（ 98. 20±7. 75） % and 4. 20 ±1. 84 d in the experimental group,（ 92. 70 ± 6. 75） %and 5. 40 ± 1. 36 d in the control group 7 d after operation respectively,which showed significant difference between the two groups（ P〈0. 05）. The Glasgow Coma Scale（ GCS） score,serum levels of superoxide dismutase（ SOD） and glutathione peroxidase,GSH-Px） were significantly higher and the level of malonaldehyde（ MDA） was significantly lower in the experimental group than those in the control group after operation（ P〈0. 05）. The incidence rate of postoperative complications was lower and the long-term efficacy was better in the experimental group than that in the control group（ P〈0. 05）.Conclusions Dynamic monitoring of intracranial pressure combined with multi-target puncture in the treatment of basal ganglia cerebral hemorrhage has significant curative effect in the short or long term,which has higher application value.