超早期立体定向双管穿刺引流术治疗大容积高血压脑出血的临床研究

A clinical study of ultra-early stereotactic double-tube puncture and drainage against massive hypertensive cerebral hemorrhage

目的探讨超早期双管穿刺术治疗大容积高血压脑出血患者的临床疗效。方法选取我院2018年1月~2019年10月入院的出血量> 70mL的高血压脑出血患者61例,随机分为实验组和对照组,实验组32例,对照组29例,实验组行立体定向双管穿刺术治疗,对照组行小骨窗开颅血肿清除术,比较两组首次血肿清除率、术后并发症发生率,比较术前和术后1周患者的格拉斯哥意识障碍评分(GCS),评估入院时和发病后1周的意识水平,记录术后6个月患者格拉斯哥预后量表(GOS)的评分情况。结果实验组手术时间、住院时间、术后并发症总发生率均低于对照组(P <0.05);两组死亡率、血肿消除时间、术后1周GCS评分、术后6个月GOS评分差异无统计学意义(P> 0.05)。结论超早期立体定向双管穿刺引流术治疗出血量>70mL的高血压脑出血,手术时间短、创伤小,及时清除脑内血肿,是治疗大容积高血压脑出血的良好方法。

Objective To explore clinical efficacy of ultra-early double-tube puncture in the treatment of the patients with massive hypertensive cerebral hemorrhage.Methods A total of 61 patients with hypertensive cerebral hemorrhage admitted to our hospital from January 2018 to October 2019 with a hemorrhage volume over 70 mL were selected and randomly divided into the experimental group and the control group,with 32 patients in the experimental group and 29 patients in the control group.The experimental group was treated with stereotactic double-tube puncture while the control group was treated with small bone window craniotomy hematoma removal.The first hematoma removal rate and the incidence of postoperative complications of the two groups were compared.The Glasgow coma scale(GCS)scores of the patients before and after one week of the operation were compared.The consciousness level at admission to the hospital and one week after the onset of the disease was assessed.The Glasgow outcome scale(GOS)scores of the patients 6 m after operation were recorded.Results The operation time,hospitalization time and total incidence of postoperative complications of the experimental group were all lower than those of the control group(P<0.05).There were no significant differences in mortality rate,hematoma elimination time,GCS scores 1 week after operation and GOS scores 6 months after operation between the two groups(P>0.05).Conclusion In the treatment of hypertensive cerebral hemorrhage with a hemorrhage volume over 70 mL,ultra-early stereotactic double-tube puncture and drainage requires short operation duration,produces small trauma,and clears the hematoma in the brain in time,which is a good therapy for massive hypertensive cerebral hemorrhage.