超早期微创穿刺引流治疗基底节区脑出血的临床效果

Clinical effect of ultra-early minimally invasive puncture and drainage on cerebral hemorrhage in basal ganglia region

目的探讨超早期微创穿刺引流治疗基底节区脑出血的临床效果。方法选择2017年1月至2018年10月在我院就诊的72例基底节区脑出血患者,均接受微创穿刺引流术治疗,根据发病到治疗时间的不同将患者分为三组,超早期组23例,发病到治疗时间≤6h;早期组28例,发病到治疗时间为>6~12h;延期组21例,发病到治疗时间为12~24h。比较三组的治疗效果。结果超早期组患者术后2周再出血率与死亡率均低于早期组与延期组,差异具有统计学意义(P<0.05)。早期组患者术后2周再出血率与死亡率均低于延期组,差异具有统计学意义(P<0.05)。术前,三组患者NIHSS及ADL评分比较,差异均无统计学意义(P>0.05)。术后3个月,超早期组与早期组的NIHSS及ADL评分均优于延期组,差异均具有统计学意义(P<0.05)。术后3个月,超早期组与早期组NIHSS及ADL评分比较,差异不具有统计学意义(P>0.05)。超早期组出血量>50mL患者的再出血率显著低于早期组,生存率显著高于早期组,差异具有统计学意义(P<0.05)。结论对于基底节区脑出血患者来说,应尽早实施微创穿刺引流术。超早期手术的应用要根据患者血肿情况选择,出血量>50mL者行超早期手术能够取得较好的手术效果。

Objective To explore the clinical effect of ultra-early minimally invasive puncture and drainage on cerebral hemorrhage in basal ganglia region.Methods From January 2017 to October 2018,72 patients with cerebral hemorrhage in basal ganglia region were selected and treated with minimally invasive puncture and drainage.The patients were divided into three groups according to the different time from onset to treatment.There were 23 cases in ultra-early group whose onset time was less than 6 hours,28 cases in early group whose onset time was>6-12 hours,and 21 cases in delayed group whose onset time was 12-24 hours.The therapeutic effects of the three groups were compared.Results The rebleeding rate and mortality at 2 weeks after operation in the ultra-early group were lower than those in the early group and the delayed group,and the differences were statistically significant(P<0.05).The rebleeding rate and mortality at 2 weeks after operation in the early group were lower than those in the delayed group,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in NIHSS and ADL scores among the three groups(P>0.05).Three months after operation,NIHSS and ADL scores of the ultra-early group and the early group were better than those of the delayed group,and the differences were statistically significant(P<0.05).Three months after operation,there were no significant differences in NIHSS and ADL scores between the ultra-early group and the early group(P>0.05).The rebleeding rate of patients with bleeding volume>50 mL in the ultra early group was significantly lower than that in the early group,the survival rate was significantly higher than that in the early goup,and the differences were statistically significant(P<0.05).Conclusion For patients with cerebral hemorrhage in basal ganglia region,minimally invasive puncture and drainage should be implemented as soon as possible.The application of ultra-early surgery should be selected based on the hematoma situation of patients.Ultra-early surgery for patients with bleeding volume>50 mL can achieve better surgical results.