锥颅穿刺引流术与钻孔穿刺引流术治疗高血压脑出血的效果比较

Effect comparison of skull puncture drainage and borehole drainage treating hypertensive cerebral hemorrhage

目的探讨锥颅穿刺引流术与钻孔引流术治疗高血压脑出血的效果。方法选取2015年3月~2019年6月我院神经外科收治的40例高血压脑出血患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组各20例。对照组患者应用钻孔穿刺引流术,观察组患者则应用锥颅穿刺引流术。比较两组患者的出血总发生率、各项手术指标、神经功能缺损评分、日常生活能力评分以及治疗效果。结果观察组患者治疗后的出血总发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者的手术时间、住院时间、血肿清除时间短于对照组,差异有统计学意义(P<0.05)。两组患者治疗前的神经功能缺损评分与日常生活能力评分比较,差异无统计学意义(P>0.05)。治疗后7 d,两组患者的神经功能缺损评分均低于本组治疗前,日常生活能力评分高于本组治疗前,差异有统计学意义(P<0.05)。观察组患者治疗后7 d的神经功能缺损评分低于对照组,日常生活能力评分高于对照组,差异有统计学意义(P<0.05)。观察组患者的治疗总有效率(95.00%)高于对照组(70.00%),差异有统计学意义(P<0.05)。结论对于高血压脑出血患者,应用锥颅穿刺引流术的方法能显著降低患者的出血率,缩短患者的住院时间和血肿清除时间,改善神经功能缺损情况,提升生活质量,值得在临床中推广应用。

Objective To explore the effect of skull puncture drainage and borehole drainage treating hypertensive cerebral hemorrhage.Methods Totally 40 patients with hypertensive cerebral hemorrhage treated in the department of neurosurgery of our hospital from March 2015 to June 2019 were selected as research subjects.They were divided into observation group(n=20)and control group(n=20)by the random number table method.Patients in the control group were treated with borehole drainage,and patients in the observation group were treated with skull puncture drainage.The total incidence of bleeding,surgical parameters,neurological impairment score,daily living ability score and therapeutic effect were compared between the two groups.Results The total incidence of bleeding in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The operation time,hospitalization time and hematoma clearance time of the observation group were shorter than those of the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in the scores of neurological impairment and the scores of daily living ability before treatment between the two groups(P>0.05).On the 7th day after treatment,the scores of neurological impairment in both groups were lower than those before treatment,and the scores of daily living ability were higher than those before treatment,with statistically significant differences(P<0.05).On the 7th day after treatment,the neurological impairment score of the observation group was lower than that of the control group,and the daily living ability score was higher than that of the control group,with statistically significant differences(P<0.05).The total effective rate of the observation group(95.00%)was higher than that of the control group(70.00%),and the difference was statistically significant(P<0.05).Conclusion For patients with hypertensive cerebral hemorrhage,skull puncture drainage can significantly reduce the bleeding rate,shorten the hospital stay,reduce the hematoma clearance time,alleviate neurological impairment and improve quality of life.It is worth promoting in the clinic.