定向软通道血肿吸引术与微创锥颅血肿碎吸术治疗脑出血的疗效比较

Clinical comparison of directional soft channel hematoma aspiration and minimally invasive cranial hematoma aspiration for cerebral hemorrhage

目的探讨定向软通道血肿吸引术与微创锥颅血肿碎吸术治疗脑出血的临床效果。方法选取本院2017年7月至2019年6月接诊的84例高血压脑出血患者,按随机数字表法分为两组,各42例。对照组行微创锥颅血肿碎吸术,实验组行定向软通道血肿吸引术。比较两组再出血率、住院时间、神经功能缺损程度、日常生活能力与并发症。结果实验组术后无再次出血,对照组术后再次出血率为14.29%(6/42),差异有统计学意义(P<0.05);实验组住院时间为(18.36±2.25)d,短于对照组的(24.75±3.08)d,差异有统计学意义(P<0.05);实验组术后美国国立卫生研究院卒中量表(NIHSS)评分略低于对照组,但差异无统计学意义;实验组术后Barthel指数评分为(65.35±4.08)分,高于对照组的(59.40±3.68)分,差异有统计学意义(P<0.05);两组术后并发症发生率比较差异无统计学意义。结论定向软通道血肿吸引术与微创锥颅血肿碎吸术治疗高血压脑出血患者安全性相似,均可有效减轻神经功能缺损程度,但前者能降低术后再次出血率,缩短住院时间,利于提高患者日常生活能力。

Objective To investigate the clinical effects of directional soft channel hematoma aspiration and minimally invasive cranial hematoma aspiration in the treatment of cerebral hemorrhage.Methods 84 patients with hypertensive intracerebral hemorrhage admitted in our hospital from July 2017 to June 2019 were selected and divided into two groups according to the random number table method,with 42 cases in each group.The control group underwent minimally invasive cranial hematoma aspiration,and the experimental group underwent directional soft channel hematoma aspiration.The rebleeding rate,length of hospital stay,degree of neurological deficit,ability of daily living and complications were compared between the two groups.Results There was no re-bleeding in the experimental group,the rate of re-bleeding in the control group was 14.29%(6/42),the difference was statistically significant(P<0.05);the hospital stay in the experimental group was(18.36±2.25)days,which was shorter than in the control group(24.75±3.08)days,the difference was statistically significant(P<0.05);the postoperative National Institutes of Health Stroke Scale(NIHSS)score of the experimental group was slightly lower than the control group,and the difference was not statistically significant;the postoperative Barthel index score of the experimental group was(65.35±4.08)scores,which was higher than that of the control group(59.40±3.68)scores,the difference was statistically significant(P<0.05);there was no significant difference in the incidence of postoperative complications between the two groups.Conclusion Directional soft channel hematoma aspiration is similar to that of minimally invasive cranial hematoma aspiration in the treatment of patients with hypertensive intracerebral hemorrhage.Both can effectively reduce the degree of neurological deficits,but the former can reduce the rate of postoperative re-bleeding and shorten the length of hospital stay.Improve the patient's daily life.