立体定向锥颅颅内血肿穿刺软通道引流术与骨瓣减压颅内血肿清除术治疗脑出血的效果比较

Effect comparison of the stereotactic cone puncture and soft channel drainage of intracranial hematoma surgery and bone flap decompression and removal of intracranial hematoma suegery in the treatment of cerebral hemorrhage

目的比较立体定向锥颅颅内血肿穿刺软通道引流术与骨瓣减压颅内血肿清除术治疗脑出血(ICH)的效果。方法选取2017年9月—2020年8月南昌三三四医院收治的82例ICH患者作为研究对象,按照随机数字表法将其分为对照组与研究组,每组各41例。对照组患者采用骨瓣减压颅内血肿清除术,研究组患者应用立体定向锥颅颅内血肿穿刺软通道引流术。比较两组患者术后72 h再出血情况、格拉斯哥预后评分(GOS)分级、术前、术后72 h美国国立卫生研究院卒中量表(NIHSS)评分及残留血肿体积。结果研究组患者术后72 h GOS分级总优良率高于对照组,术后72 h再出血率低于对照组,差异有统计学意义(P<0.05)。研究组患者术后72 h残留血肿体积小于对照组,差异有统计学意义(P<0.05)。研究组患者术后72 h NIHSS评分低于对照组,差异有统计学意义(P<0.05)。结论立体定向锥颅颅内血肿穿刺软通道引流术能有效改善ICH患者神经功能和再出血情况,消除残留血肿,帮助患者病情恢复。

Objective To compare the effect of stereotactic cone puncture and soft channel drainage of intracranial hematoma surgery and bone flap decompression and removal of intracranial hematoma surgery in the treatment of cerebral hemorrhage(ICH).Methods A total of 82 patients with ICH in Nanchang 334 Hospital from September 2017 to August 2020 were selected as subjects and divided into the study group and the control group according to random number table method,with 41 cases in each group.The control group was given bone flap decompression and removal of intracranial hematoma surgery,and the study group was given stereotactic cone puncture and soft channel drainage of intracranial hematoma surgery.The rebleeding situation and Glasgow outcome scale score(GOS)grading of the two groups of patients 72 hours after surgery,National Institutes of Health stroke scale(NIHSS)score and residual hematoma volume before and 72 h after surgery were compared.Results The total excellent and good rate of 72 h GOS grading in the study group was higher than that of the control group,and the rebleeding rate at 72 h after the surgery was lower than that of the control group,and the differences were statistically significant(P<0.05).The volume of residual hematoma in the study group was smaller than that in the control group at 72 hours after surgery,and the difference was statistically significant(P<0.05).The NIHSS score of the study group was lower than that of the control group at 72 h after surgery,and the difference was statistically significant(P<0.05).Conclusion Stereotactic cone puncture and soft channel drainage of intracranial hematoma surgery can significantly improve the nerve function and rebleeding of ICH patients,eliminate residual hematoma,and help patients recover.