脑室外引流联合开颅血肿清除治疗脑出血破入脑室效果分析

Effect Analysis of External Ventricular Drainage Combined with Craniotomy for Hematoma Removal in the Treatment of Intracerebral Hemorrhage

目的:探讨脑室外引流联合开颅血肿清除治疗脑出血破入脑室效果。方法:将2017年1月~2019年10月在某院神经外科手术治疗的80例脑出血破入脑室患者随机分为对照组和观察组各40例,对照组单行脑室外引流术治疗,观察组行脑室外引流联合开颅血肿清除治疗,对比两组的疗效、并发症发生率、术后6个月各项功能评分、术后6个月的生活质量。结果:观察组术后3d、7d的血肿清除率明显高于对照组,术后2周的GCS评分明显高于对照组,NICU治疗时间、住院时间明显短于对照组(P<0.05);观察组肺部感染、颅内感染、再出血等并发症发生率明显低于对照组(P<0.05);观察组术后6个月的GOS评分明显高于对照组,而MRS评分、NIHSS评分明显低于对照组(P<0.05);观察组术后6个月的ADL分级明显低于对照组(P<0.05)。结论:脑室外引流联合开颅血肿清除治疗脑出血破入脑室效果显著,能提高血肿清除率,缩短治疗时间,改善神经功能及预后,提高生活质量,具有积极的临床意义。

Objective:To investigate the effect of external ventricular drainage combined with craniotomy for hematoma removal in the treatment of intracerebral hemorrhage.Methods:From January 2017 to October 2019,80 patients with cerebral hemorrhage broken into ventricles in a hospital were selected and randomly divided into two groups.The control group was given the single external ventricular drainage treatment,and the observation group received external ventricular drainage combined with craniotomy for hematoma removal,then the curative effect,incidence of complication,and the function score and the quality of life 6 months after surgery were compared between the two groups.Results:The hematoma clearance rate of the observation group was significantly higher than that of the control group on day 3 and day 7 after surgery,the GCS score 2 weeks after surgery was significantly higher than that of the control group,and the treatment time and hospitalization time of the NICU were significantly shorter than thoe of the control group(P<0.05).The incidence of pulmonary infection,intracranial infection,rebleeding and other complications in the observation group was significantly lower than that in the control group(P<0.05).The GOS score of the observation group 6 months after the operation was significantly higher than that of the control group,while the MRS score and NIHSS score were significantly lower than those of the control group(P<0.05).The grade of ADL in the observation group 6 months after the operation was significantly lower than that in the control group(P<0.05).Conclusion:External ventricular drainage combined with craniotomy for hematoma removal is effective in the treatment of intracerebral hemorrhage,which can improve hematoma clearance,shorten treatment time,improve nerve function and prognosis,improve quality of life,and has positive clinical significance.