开颅血肿清除和神经导航引导下血肿抽吸术治疗高血压脑出血的疗效观察

Efficacy observation of craniotomy hematoma removal and hematoma aspiration under neuronavigation in the treatment of patients with hypertensive intracerebral hemorrhage

目的探讨骨瓣开颅血肿清除术和神经导航引导下微创血肿抽吸术治疗高血压脑出血的疗效及其对患者预后的影响。方法收集2014年1月至2018年12月在我院接受治疗HICH患者110例,其中55例行骨瓣开颅血肿清除术(开颅组),55例行神经导航定位下微创血肿抽吸术(微创组);比较两组手术前后美国国立卫生院脑卒中量表(NIHSS)评分及术后并发症、病死率、日常生活能力。结果术后14 d,两组NIHSS评分较术前均明显降低(P<0.05),组间比较差异无统计学意义(P>0.05)。微创组术后肺部感染、消化道出血发生率均明显低于开颅组(P<0.05)。术后3个月微创组日常生活能力恢复明显优于开颅组(P<0.05),两组病死率比较差异无统计学意义(P>0.05)。结论相比于骨瓣开颅血肿清除术,神经导航引导下微创血肿抽吸术治疗高血压脑出血疗效显著,能有效减少术后并发症,促进术后日常生活能力恢复。

Objective To explore the efficacy of craniotomy hematoma removal and hematoma aspiration under neuronavigation in the treatment of patients with hypertensive intracerebral hemorrhage and their effect on prognosis.Methods One hundred and ten continuous patients with hypertensive cerebral hemorrhage,admitted in our hospital from January 2014 to December 2018 were collected.Of the 110 patients,55 patients underwent craniotomy hematoma removal(craniotomy group)and 55 patients underwent minimally invasive hematoma aspiration under neuronavigation(minimally invasive group).National Institutes of Health Stroke Scale(NIHSS)score and postoperative complications,mortality rate,and the excellent and good rate of daily living ability were compared between the two groups before and after operation.Results After 14d of operation,the NIHSS scores in the two groups were significantly lower than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence rates of postoperative pulmonary infection and gastrointestinal bleeding were lower in the minimally invasive group than those in the craniotomy group(P<0.05).After 3 months of operation,the recovery of daily living ability in the minimally invasive group was significantly better than that in the craniotomy group(P<0.05).There was no significant difference in the mortality rate between the two groups(P>0.05).Conclusion Compared with craniotomy hematoma removal,minimally invasive hematoma aspiration under neuronavigation has a significant efficacy in the treatment of hypertensive intracerebral hemorrhage,and it can effectively reduce the postoperative complications and promote the recovery of postoperative daily living ability.