定向软通道穿刺抽吸引流术治疗基底节区自发性脑出血效果观察及对患者神经功能的影响

Clinical effect of directional soft-channel puncture and suction drainage in the treatment of spontaneous cerebral hemorrhage in basal ganglia and its influence on neurological function

目的探讨定向软通道穿刺抽吸引流术治疗基底节区自发性脑出血患者的临床效果及对患者神经功能的影响。方法选择建德市第一人民医院于2017年1月至2018年12月收治的基底节区自发性脑出血患者61例,按照随机数字表法分为对照组30例与观察组31例。对照组采用常规保守治疗,观察组在对照组基础上采用定向软通道穿刺抽吸引流术治疗。比较两组治疗疗效,治疗前、治疗后1周、治疗后2周神经功能缺损程度(NIHSS)评分、日常生活活动能力(ADL)评分和脑水肿体积变化,及并发症发生情况。结果观察组总有效率(96.77%)高于对照组(76.67%)(χ^2=3.989,P<0.05);观察组NIHSS评分治疗后1周(16.54±2.19)分、治疗后2周(9.12±1.24)分,均低于对照组的(19.98±1.65)分、(13.25±2,37)分(t=6.911、8.568,均P<0.05);观察组ADL评分治疗后1周(43.42±5.67)分、治疗后2周(63.98±3.46)分,均高于对照组的(37.89±2.86)分、(52.37±4.10)分(t=4.785、11.967,均P<0.05);观察组脑水肿体积治疗后1周(12.08±2.14)mL、治疗后2周(4.37±0.89)mL,均小于对照组的(16.89±3.20)mL、(9.74±1.07)mL(t=6.922、21.339,均P<0.05)。观察组并发症发生率(6.45%)低于对照组(30.00%)(χ^2=5.720,P<0.05)。结论定向软通道穿刺抽吸引流术治疗基底节区自发性脑出血患者临床效果良好,可减轻神经功能缺损程度,并发症少,值得临床研究。

Objective To investigate the clinical effect of directional soft-channel puncture and suction drainage in the treatment of spontaneous cerebral hemorrhage in basal ganglia and its influence on neurological function.Methods From January 2017 to December 2018,61 patients with spontaneous cerebral hemorrhage in basal ganglia were selected in the First People's Hospital of Jiande.According to the random table method,they were divided into control group(30 cases)and observation group(31 cases).The control group was treated conservatively,while the observation group was treated with directional soft-channel puncture and suction drainage combined with conventional therapy.The therapeutic effects,NIHSS score,ADL score,brain edema volume change and complications were compared before treatment,1 week after treatment and 2 weeks after treatment.Results The total effective rate of the observation group(96.77%)was higher than that of the control group(76.67%)(χ^2=3.989,P<0.05).The NIHSS score of the observation group was(16.54±2.19)points at one week after treatment and(9.12±1.24)points at two weeks after treatment,which were lower than those of the control group[(19.98±1.65)points and(13.25±2,37)points](t=6.911,8.568,all P<0.05).The ADL score of the observation group was(43.42±5.67)points at one week after treatment and(63.98±3.46)points at two weeks after treatment,which were higher than those of the control group[(37.89±2.86)points and(52.37±4.10)points](t=4.785,11.967,all P<0.05).The volume of brain edema of the observation group was(12.08±2.14)mL at 1 week after treatment and(4.37±0.89)mL at 2 weeks after treatment,which were lower than those of the control group[(16.89±3.20)mL and(9.74±1.07)mL](t=6.922,21.339,all P<0.05).The incidence of complications in the observation group(6.45%)was lower than that in the control group(30.00%)(χ^2=5.720,P<0.05).Conclusion Directional soft-channel puncture and suction drainage is effective in the treatment of spontaneous cerebral hemorrhage in basal ganglia,which can reduce the degree of neurological deficit and with fewer complications,and it is worthy of clinical study.