立体定向微创引流术治疗高血压小脑出血预后分析

Prognostic analysis of stereotactic minimally invasive drainage for hypertensive cerebellar hemorrhage

目的探讨立体定向微创引流术治疗高血压小脑出血的预后情况。方法选取2017年1月—2020年1月采用立体定向微创引流术治疗的高血压小脑出血患者38例为研究组,并以同期基线资料匹配的高血压小脑出血开颅手术治疗患者38例为对照组。比较2组住院时间、血肿排空时间、并发症发生率、再出血率、术后3个月和术后半年的日常生活能力(Barthel指数)评分、美国国立卫生院卒中量表(NIHSS)评分、Glasgow预后分级(GOS)等。结果研究组住院时间短于对照组,血肿排空时间长于对照组,研究组术后3个月和术后半年的NIHSS评分和并发症发生率均低于对照组,研究组术后3个月和术后半年的Barthel指数评分以及GOS分级为Ⅳ级和Ⅴ级患者比例均高于对照组(P<0.05);2组再出血率比较差异无统计学意义(P>0.05)。结论立体定向微创引流术治疗高血压小脑出血定位准确,创伤小,并发症少,术后恢复快,可促进神经功能恢复和改善预后。

Objective To investigate the prognosis of stereotactic minimally invasive drainage in the treatment of hypertensive cerebellar hemorrhage.Methods From January 2017 to January 2020,38 patients with hypertensive cerebellar hemorrhage treated with stereotactic minimally invasive drainage were selected as the study group,and 38 patients matched with baseline data and had hypertensive cerebellar hemorrhage craniotomy treatment during the same period were selected as the control group.Hospital stay time,hematoma emptying time,complication rate,rebleeding rate,3 months and half a year after surgery ability of daily living(ADL)score,National Institutes of Health Neurological Impairment Score(NIHSS),and Glasgow prognostic classification(GOS)of the two groups were compared.Results The hospital stay time in the study group was shorter than the control group and the hematoma emptying time in the study group was longer than the control group.The 3 months and half a year after operation NIHSS score and complication rate of the study group were lower than those of the control group.The 3 months and half a year after operation ADL score and proportion of patients with GOS grade IV and V were higher than those in the control group(P<0.05);There was no significant difference in the rebleeding rate between the two groups(P>0.05).Conclusion Stereotactic minimally invasive drainage for the treatment of hypertensive cerebellar hemorrhage has accurate positioning,less trauma,fewer complications,and quick postoperative recovery,which can promote the recovery of nerve function and improve the prognosis.