CT引导下立体定向微创引流术治疗高血压脑出血的临床疗效及对神经功能的影响

The clinical efficacy of stereotactic minimally invasive drainage under CT guidance in treating hypertensive cerebral hemorrhage and its influences on neurological function

目的:探究分析CT引导下立体定向微创引流术治疗高血压脑出血的临床疗效及其对神经功能的影响。方法:选取96例高血压脑出血患者,按照手术方式的不同将其分为对照组和观察组,每组48例。对照组给予常规开颅手术治疗,观察组给予CT引导下立体定向微创引流术治疗,对比两组临床疗效,术前、术后2周及术后1个月的脑水肿、血清神经元特异性烯醇化酶(NSE)浓度,术后随访6个月时的格拉斯哥预后量表(GOS)分级。结果:两组临床总有效率比较,差异无统计学意义。术后2周及1个月,对照组和观察组脑水肿体积和NSE浓度水平均较术前明显降低,差异有统计学意义(F对照组=7.365,F=15.665;F观察组=12.38,F=19.901;P<0.05);术后2周及1个月观察组脑水肿体积和NSE浓度水平均低于对照组,差异有统计学意义(t脑水肿体积=16.477,t=34.764;tNSE水平=11.889,t=10.711;P<0.05)。术后6个月,观察组GOS分级优于对照组,差异有统计学意义(Z=9.986,P<0.05)。结论:CT引导下立体定向微创引流术治疗高血压脑出血的临床疗效显著,能够帮助减轻脑水肿,促进恢复神经功能。

Objective: To explore and analyze the clinical efficacy of stereotactic minimally invasive drainage under computed tomography(CT) guidance in treating hypertensive cerebral hemorrhage and its influences on neurological function. Methods: 96 patients with hypertensive cerebral hemorrhage admitted to Hospital were selected and were randomly divided into control group and observation group, with 48 cases in each group. The control group adopted routine craniotomy, and the observation group adopted stereotactic minimally invasive drainage under CT guidance. The clinical efficacies, and the cerebral edema, serum concentration of neuron-specific enolase(NSE) pre operation, the 2 th week post operation and the 1 st month post operation, and the grading of Glasgow outcome score(GOS) in 6 months postoperative follow-up between two groups were compared. Results: There was no significant difference in the total effective rate between the two groups. The volume of cerebral edema and the concentration of NSE both control group and observation group at the 2 th week and the 1 st month post operation were significantly lower than those pre operation(Fcontrol group=7.365, F=15.665, Fobservation group=12.38, F=19.901, P<0.05). At the 2 th week and the 1 st month, the volume of cerebral edema and NSE concentration of observation group were significantly lower than those of control group(tvolume of cerebral edema=16.477, t=34.764, tNSE level=11.889, t=10.711, P<0.05). At the 6 th months post operation, the GOS grading of observation group was significantly superior to that of control group(Z=9.986, P<0.05). Conclusion: CT-guided stereotactic minimally invasive drainage has significantly clinical efficacy in treating hypertensive cerebral hemorrhage and it can help to reduce cerebral edema and promote the recovery of nerve function.