锁孔清除术与穿刺抽吸术治疗基底核区高血压脑出血的疗效及对患者血清NSE水平的影响

Effect of Keyhole Removal and Puncture Aspiration on Hypertensive Cerebral Hemorrhage in Basal Ganglia and its Effect on Serum NSE Levels

目的:探讨基底核区高血压脑出血采取不同微创术式治疗的疗效。方法:选取我院接收的68例基核节区高血压脑出血患者,时间为2014年5月至2017年5月期间,随机分为穿刺组(n=34,采取穿刺抽吸术)与锁孔组(n=34,采取锁孔清除术),对疗效及相关指标进行观察。结果:锁孔组的手术时间、术中出血量高于穿刺组(P <0.05);锁孔组的血肿清除率、ADL评分高于穿刺组,引流管拔除时间较穿刺组明显要短(P <0.05);术后14天时,锁孔组的NIHSS评分及血清NSE水平均较穿刺组明显要低(P <0.05);两组的病死率及术后并发症发生率比较无明显差异(P> 0.05)。结论:基核节区高血压脑出血患者采取锁孔清除术早期血肿清除率高,患者的短期预后更好,值得推广。

Objective: To investigate the efficacy of different minimally invasive surgery for hypertensive cerebral hemorrhage in basal ganglia. Methods: Sixty-eight patients with hypertensive cerebral hemorrhage in the basal ganglia were enrolled in our hospital. The patients were randomly divided into the puncture group(n = 34, puncture aspiration) and the keyhole group(n = 34, keyhole removal was performed) from May 2014 to May 2017, and the efficacy and related indicators were observed. Results: The operation time and intraoperative blood loss of the keyhole group were higher than that of the puncture group(P < 0.05). The hematoma clearance rate and ADL score of the keyhole group were higher than that of the puncture group. The drainage tube removal time was significantly shorter than that of the puncture group(P < 0.05). At 14 days after operation, the NIHSS score and serum NSE level in the keyhole group were significantly lower than those in the puncture group(P < 0.05). There was no significant difference between the two groups in mortality and postoperative complications(P > 0.05). Conclusion: Patients with hypertensive cerebral hemorrhage in the basal ganglia have a high clearance rate of hematoma in the early stage of keyhole clearance. The short-term prognosis is better and worthy of promotion.