软硬通道穿刺引流术在颅内脓肿的应用研究

Application of soft and hard channel puncture drainage in intracranial abscess

目的对比分析软通道与硬通道穿刺引流在治疗颅内脓肿中的价值。方法回顾性分析2005年1月至2017年12月该科收治的90例接受微创治疗的颅内脓肿患者的临床资料,其中软通道治疗51例,硬通道治疗39例,对比分析患者术后脓肿清除率、并发症发生率及生活自理能力。结果术后6周软通道组脓肿完全清除率为90.20%,硬通道组脓肿完全清除率为89.74%,二者差异无统计学意义(P>0.05);硬通道组术后癫痫的发生率高于软通道组,差异有统计学意义(P<0.05),但总的并发症发生率两组间差异无统计学意义(P>0.05);两组术后Barthel指数均较治疗前明显提高(P<0.01),术后6个月软通道组的Barthel指数[(85.65±10.19)分]与硬通道组[(81.58±10.01)分]比较,差异无统计学意义(P>0.05)。结论软通道和硬通道穿刺引流对脑脓肿患者均可起到良好的脓液清除效果,治疗时需要结合患者实际情况进行选择。

Objective To compare the value of soft channel and hard channel puncture drainage in the treatment of intracranial abscess.Methods The clinical data of 90 patients with intracranial abscess undergoing minimally invasive treatment from January 2005 to December 2017 were retrospectively analyzed,including 51 cases of soft channel treatment and 39 cases of hard channel treatment.Under the two kinds of model,the abscess clearance rate,incidence rate of complications and self care ability of daily living after surgery were compared between the two treatment modes.Results After 6 weeks,the abscess clearance rate in the soft channel treatment group was 90.20%,and which in the hard channel treatment group was 89.74%,and the difference between the two groups was not statistically significant(P>0.05);the incidence rate of postoperative epilepsy complications after 6 months in the hard channel group was greater than that in the soft channel group,and the difference was statistically significant(P<0.05),but the total complication occurrence rate had no statistical difference between the two groups(P>0.05);the Barthel index after 6-month treatment in the two groups was significantly increased(P<0.05),which in the soft and hard channels were 85.65±10.19 and 81.58±10.01 respectively,and the difference between the two groups was not statistically significant(P>0.05).Conclusion Both soft channel and hard channel puncture drainage can play a good role for removing pus in the patients with brain abscess.In the treatment of brain abscess,it needs to be selected in accordance with the actual situation of the patient.