微创定向钻孔软通道血肿穿刺引流术与开颅术治疗高血压脑出血对照分析

Contrastive Analysis of Minimally Invasive Directional Drilling Soft Channel Hematoma Puncture Drainage and Craniotomy in Patients with Hypertensive Intracerebral Hemorrhage

目的探究微创定向钻孔软通道血肿穿刺引流术与开颅术在高血压脑出血患者中应用价值,并进行临床对比研究。方法本次研究纳入120例高血压脑出血患者均由我院2015年1月至2018年4月收治,并以随机数字表法将其分为观察组与对照组,对照组患者(60例)行开颅手术治疗,观察组患者(60例)行微创定向钻孔软通道血肿穿刺引流术治疗,对比两组患者手术结果、血肿彻底清除率、术后并发症率、术后疼痛评分(视觉模拟疼痛评分,VAS)、住院时间及术前、术后1w及术后3个月Barthel指数。结果两组患者均成功完成手术,手术成功率100.00%,P>0.05,观察组患者血肿彻底清除率(100.00%)显著高于对照组(93.33%),P<0.05;观察组患者术后并发症率(3.33%)低于对照组(13.33%),P<0.05;观察组患者术后VAS疼痛量表评分优于对照组,住院时间短于对照组,P<0.01;术前及术后1w两组患者Barthel指数相当,P>0.05,术后3个月,观察组患者Barthel指数优于对照组,P<0.01。结论微创定向钻孔软通道血肿穿刺引流术与开颅术在高血压脑出血均具有一定应用价值,前者血肿彻底清除率更高,且术后患者并发症率低,功能恢复好,疼痛轻,值得推广及应用。

Objective To explore the application value of minimally invasive directional drilling soft channel hematoma puncture drainage and craniotomy in the patients with hypertensive intracerebral hemorrhage,and to conduct a clinical comparative study. Methods 120 patients with hypertensive intracerebral hemorrhage treated in our hospital from January 2015 to April 2018 were selected and randomly divided into two groups,observation group and control group,with 60 patients in each group. The control group was given craniotomy,while the observation group was treated with minimally invasive directional drilling soft channel hematoma puncture drainage. The two groups were compared in surgical results,complete clearance rate of hematoma,postoperative complication rate,postoperative pain score (visual analogue scale,VAS),length of hospital stay,and Barthel Index before operation,1 week after operation and 3 months after operation. Results The surgeries were successful in the two groups,with a surgical success rate of 100.00%, P >0.05. The complete clearance rate of hematoma in the observation group (100.00%) was significantly higher than that in the control group (93.33%), P <0.05. The postoperative complication rate (3.33%) of the observation group was lower than that of the control group (13.33%), P <0.05. The observation group presented better postoperative pain score and shorter stay length than the control group, P < 0.01. The Barthel Index of the two groups was the same before and 1 week after surgery, P >0.05. The Barthel Index 3 months after surgery of the observation group was superior to that of the control group( P <0.01). Conclusion Both minimally invasive directional drilling soft channel hematoma puncture drainage and craniotomy have certain application value in hypertensive intracerebral hemorrhage. The former has higher complete clearance rate of hematoma,lower postoperative complication rate,better functional recovery and less pain,which is worthy of promotion and application.