微创血肿引流术治疗老年高血压脑出血的临床效果

Clinical effect of minimally invasive hematoma drainage in the treatment of senile hypertensive intracerebral hemorrhage in the elderly

目的探讨微创血肿引流术治疗老年高血压脑出血的临床效果。方法选取我院2016年3月至2018年3月收治的220例老年高血压脑出血患者作为研究对象,并随机将其分为研究组和对照组,各110例。对照组采用开颅血肿清除术进行治疗,研究组采用微创血肿引流术进行治疗。比较两组患者的临床指标、NIHSS、Barthel指数、GCS、mRS评分、炎症因子、脑出血标志物水平及术后并发症发生情况。结果研究组的手术时间和住院时间均显著短于对照组,术中出血量显著少于对照组,血肿清除率显著高于对照组,血脑屏障指数显著优于对照组(P<0.05)。术后2个月,两组的NIHSS、Barthel指数、GCS及mRS评分均显著改善,且研究组优于对照组(P<0.05)。术后2个月,两组患者的hs-CRP、NSE、NT-proBNP及HMGB1水平均显著降低,且研究组低于对照组(P<0.05)。研究组的术后并发症总发生率显著低于对照组(P<0.05)。结论微创血肿引流术治疗老年高血压脑出血效果良好,且创伤较小,能显著改善患者的炎症因子和神经功能,提高术后的生活质量,值得临床推广应用。

Objective To explore the clinical effect of minimally invasive hematoma drainage in the treatment of senile hypertensive intracerebral hemorrhage in the elderly. Methods A total of 220 elderly patients with hypertensive intracerebral hemorrhage admitted in our hospital from March 2016 to March 2018 were selected as study objects and randomly divided into study group and control group, with 110 cases in each group. The control group was treated with craniotomy hematoma clearance, while the study group was treated with minimally invasive hematoma drainage. The clinical indicators, scores of NIHSS, Barthel index, GCS and mRS, levels of inflammatory factors and markers of cerebral hemorrhage and complications were compared between the two groups. Results The operation time and hospitalization time of the study group were significantly shorter than those of the control group, the intraoperative bleeding volume was significantly less than that of the control group, the clearance rate of hematoma was significantly higher than that of the control group, and the blood-brain barrier index was significantly better than that of the control group(P<0.05). Two months after operation, the scores of NIHSS,Barthel index, GCS and mRS of the two groups significantly improved, and those of the study group were better than the control group(P<0.05). Two months after operation, the levels of hs-CRP, NSE, NT-proBNP and HMGB1 in the two groups significantly decreased, and those of the study group were significantly lower than the control group(P <0.05). The total incidence of postoperative complications in the study group was significantly lower than that in the control group( P<0.05).Conclusion Minimally invasive hematoma drainage is effective in the treatment of senile hypertensive intracerebral hemorrhage with less trauma. It can significantly improve the inflammatory factors and nerve function of patients and improve the quality of life after operation. It is worthy of clinical promotion and application.