探讨小骨窗血肿清除术与微创血肿穿刺术治疗高血压脑出血的效果

To investigate the efficacy of small bone window hematoma removal and minimally invasive hematoma puncture in the treatment of hypertensive cerebral hemorrhage

目的探究微创血肿穿刺术、小骨窗血肿清除术治疗高血压脑出血(HCH)的临床效果。方法选取2017年1月至2019年12月本院收治的高血压脑出血患者98例,经检查所有患者均达到手术出血量标准,患者清醒、嗜睡、朦胧未达到昏迷,根据手术方式不同分为对照组与观察组,各49例。观察组采用微创血肿穿刺术,对照组采用小骨窗血肿清除术,比较两组手术结局。结果观察组治疗总有效率为93.88%,低于对照组的79.59%(P<0.05)。观察组手术时间、住院时间短于对照组;观察组出血量、残余血肿量少于对照组(P<0.05)。术前,两组MRS、SSS评分比较差异无统计学意义;术后,观察组SSS评分、BD指数高于对照组,MRS评分低于对照组(P<0.05)。观察组并发症总发生率为4.08%,低于对照组的20.41%(P<0.05)。结论在HCH治疗中,与小骨窗血肿清除术相比,微创血肿穿刺术能有效减少术中出血量,缩短手术及住院时间,术后感染率较低,具有脑损伤小、再出血风险低、责任血管不断流等优势,具有临床推广价值。

Objective To investigate the clinical effects of minimally invasive hematoma puncture and small bone window hematoma removal in the treatment of hypertensive cerebral hemorrhage(HCH).Methods 98 patients with hypertensive cerebral hemorrhage in our hospital from January 2017 to December 2019 were selected.They were divided into the control group and observation group according to different surgical methods,with 49 cases in each group.The observation group was treated with minimally invasive hematoma puncture,and the control group was treated with small bone window hematoma clearance.The surgical outcomes were compared between the two groups.Results The total effective rate of the observation group was 93.88%,which was lower than 79.59%in the control group(P<0.05).The operation time and hospital stay of the observation group were shorter than those of the control group;the amount of bleeding and residual hematoma in the observation group were less than those in the control group(P<0.05).There was no significant difference in MRS and SSS scores between the two groups before surgery(P<0.05);after operation,the SS score and BD index of observation group were higher than those of the control group,and the MRS score was lower than that of the control group(P<0.05).The total incidence of complications in the observation group was 4.08%,which was lower than 20.41%in the control group(P<0.05).Conclusion In the treatment of HCH,compared with small bone window hematoma removal surgery,minimally invasive hematoma puncture can effectively reduce the amount of intraoperative blood loss,shorten the duration of surgery and hospitalization,lower postoperative infection rate,and has the advantages of less brain injury,less risk of rebleeding,and continuous flow of responsible blood vessels.