软通道微创穿刺治疗老年高血压脑出血后认知、负性情绪改变研究

Soft-channel Minimally Invasive Puncture for Treatment of Cognitive and Negative Emotion Changes in Elderly Hypertensive Cerebral Hemorrhage

目的研究软通道微创穿刺治疗老年高血压脑出血后对认知、负性情绪的影响。方法选取2016年4月～2017年4月于本院就诊的100例老年高血压脑出血患者纳入研究对象,以随机数表法分为观察组与对照组,各50例。对照组实施常规骨瓣开颅手术,观察组实施软通道微创穿刺引流术。对比两组手术时间、术中出血量、下床活动时间、住院时间、MMSE评分、MoCA评分、HAMA评分、HAMD评分各项指标,另外统计并发症发生率及死亡率。结果观察组手术时间、下床活动时间、住院时间显著少于对照组,且术中出血量显著少于对照组,差异有统计学意义(P <0.05);观察组术后MMSE、MoCA评分与术前及对照组术后对比显著提高,差异有统计学意义(P <0.05),观察组术后不同时点HAMA、HAMD评分显著低于对照组,差异有统计学意义(P <0.05);观察组术后并发症总发生率显著低于对照组,差异有统计学意义(P <0.05),其中3例死亡,2例因肺部感染死亡,1例因再出血死亡。结论软通道微创穿刺引流术可降低老年高血压脑出血患者术后认知功能障碍、焦虑、抑郁风险,且并发症发生率低,值得临床应用。

Objective To study the effects of soft-channel minimally invasive puncture on cognitive and negative emotions in elderly hypertensive cerebral hemorrhage.Methods A total of 100 elderly hypertensive cerebral hemorrhage patients who were admitted to our hospital from April 2016 to April 2017 were randomly divided into control group(n=50)and observation group(n=50).Patients in the control group underwent routine craniotomy,while patients in the observation group underwent soft-channel minimally invasive puncture drainage.The operation time,intraoperative blood loss,time to bed,hospitalization time,MMSE score,MoCA score,HAMA score,and HAMD score were compared between both groups.The complication rate and mortality were also counted.Results The operation time,the time of getting out of bed,and the hospitalization time in the observation group were significantly less than those in the control group,and the intraoperative blood loss was significantly less than that in the control group(P<0.05).The postoperative MMSE and MoCA scores in the observation group were significantly higher than those in the preoperative and control groups(P<0.05).The HAMA and HAMD scores were significantly lower in the observation group at different time points than that in the control group(P<0.05).The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05),of which 3 died and 2 died of lung One infection died and one died of rebleeding.Conclusion Softchannel minimally invasive puncture drainage can reduce the risk of postoperative cognitive dysfunction,anxiety and depression in elderly patients with hypertensive intracerebral hemorrhage,and the incidence of complications is low,which is worthy of clinical application.