微创穿刺引流联合开颅血肿清除术治疗高血压脑出血合并脑疝患者的效果

Effect of minimally invasive puncture drainage combined with craniotomy hematoma evacuation in the treatment of patients with hypertensive cerebral hemorrhage and cerebral hernia

目的探讨高血压脑出血合并脑疝患者采用微创穿刺引流联合开颅血肿清除术治疗的临床效果。方法选取2013年3月~2017年9月我院收治的214例高血压脑出血合并脑疝患者作为研究对象,根据手术方式的不同将其分为对照组(103例)与观察组(111例)。对照组患者行开颅血肿清除术,观察组患者行微创穿刺引流联合开颅血肿清除术。记录两组患者的解除脑组织受压时间、术后清醒时间、住院时间以及术后并发症发生情况,比较两组患者的治疗效果,并于术后6个月采用格拉斯哥转归量表(GOS)评价预后情况,采用健康调查简表(SF-36)评价其生活质量。结果观察组患者的治疗总有效率为89.19%,高于对照组的77.67%,差异有统计学意义(P<0.05)。观察组患者的解除脑组织受压时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者的术后清醒时间短于对照组,差异有统计学意义(P<0.05)。观察组患者的术后并发症总发生率为15.32%,低于对照组的28.16%,差异有统计学意义(P<0.05)。观察组患者的预后情况优于对照组,差异有统计学意义(P<0.05)。观察组患者术后6个月的生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论高血压脑出血合并脑疝患者采用微创穿刺引流联合开颅血肿清除术效果良好,能有效改善其预后,提高其生活质量。

Objective To explore clinical effect of minimally invasive puncture drainage combined with craniotomy hematoma evacuation in the treatment of patients with hypertensive cerebral hemorrhage and cerebral hernia.Methods A total of 214 patients with hypertensive cerebral hemorrhage and cerebral hernia treated in our hospital from March 2013 to September 2017 were selected as the research subjects.They were divided into the control group(103 cases)and the observation group(111 cases)according to different surgical methods.The patients in control group underwent craniotomy hematoma evacuation,while patients in observation group underwent minimally invasive puncture drainage combined with craniotomy hematoma evacuation.The time of relieving brain tissue pressure,postoperative awake time,hospitalization time and incidence of postoperative complications in both groups were recorded.The treatment effect was compared between the two groups.At 6 months after surgery,Glasgow outcome scale(GOS)was applied to evaluate prognosis,and the quality of life was evaluated by the MOS item short from health survey(SF-36).Results The total effective rate of treatment in the observation group was 89.19%,which was higher than 77.67%in the control group,and the difference was statistically significant(P<0.05).The time of relieving brain tissue pressure and hospitalization time in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).The postoperative awake time in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The total incidence rate of postoperative complications in the observation group was 15.32%,which was lower than 28.16%in the control group,and the difference was statistically significant(P<0.05).The prognosis of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).The quality of life scores of patients in the observation group at 6 months after surgery were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The effect of minimally invasive puncture drainage combined with craniotomy hematoma evacuation is good in patients with hypertensive cerebral hemorrhage combined with cerebral hernia,which can effectively improve their prognosis,and increase quality of life.