显微手术与保守治疗中等量幕上自发性脑出血的临床效果

Clinical effects of microsurgery and conservative treatment of moderate amounts of supratentorial spontaneous intracerebral hemorrhage

目的比较显微手术与保守治疗中等量幕上自发性脑出血的临床效果。方法选择2018年1月至2020年2月收治的100例中等量幕上自发性脑出血患者作为研究对象,根据随机数字表法将其分为对照组和试验组,各50例。对照组采用保守治疗,试验组采用显微手术治疗。比较两组的血肿量、GCS、GOS、NFDS评分、并发症发生情况与死亡情况、ICU入住时间、住院时间及生活质量评分。结果治疗后,两组的血肿量均少于治疗前,GCS、GOS评分均高于治疗前,NFDS评分均低于治疗前,且试验组的血肿量及GCS、GOS、NFDS评分均优于对照组(P<0.05)。试验组的并发症总发生率为4.00%,低于对照组的16.00%,差异具有统计学意义(P<0.05);两组的死亡率比较,差异无统计学意义(P>0.05)。试验组的ICU入住时间、住院时间均短于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的SF-36各维度评分均较治疗前升高,且试验组高于对照组(P<0.05)。结论中等量幕上自发性脑出血患者接受显微手术与保守治疗均可获得一定的效果,其中显微手术的应用,可更好地清除患者的血肿,改善神经功能缺损程度、昏迷程度、预后情况及生活质量,缩短康复时间,值得临床推广应用。

Objective To compare the clinical effects of microsurgery and conservative treatment of moderate amounts of supratentorial spontaneous intracerebral hemorrhage.Methods One hundred patients with moderate amounts of supratentorial spontaneous intracerebral hemorrhage treated from January 2018 to February 2020 were selected as the research objects.According to the random number table method,the patients were divided into control group and experimental group,with 50 cases in each group.The control group was given conservative treatment,and the experimental group was treated with microsurgery.The hematoma volume,GCS,GOS,NFDS scores,complications and deaths,ICU stay time,hospitalization time and quality of life score were compared between the two groups.Results After treatment,the volume of hematoma in the two groups was less than that before treatment,the GCS and GOS scores were higher than those before treatment,and the NFDS score was lower than that before treatment,and the volume of hematoma,GCS,GOS and NFDS scores in the experimental group were better than those in the control group(P<0.05).The total incidence of complications in the experimental group was 4.00%,which was lower than 16.00%in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in mortality between the two groups(P>0.05).The ICU stay time and hospitalization time in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the each dimension scores of SF-36 in both groups were higher than those before treatment,and those in the experimental group were higher than the control group(P<0.05).Conclusion Patients with moderate amounts of supratentorial spontaneous intracerebral hemorrhage can obtain certain results by microsurgery and conservative treatment.The application of microsurgery can better remove the hematoma of patients,improve the degree of neurological deficit,coma,prognosis and quality of life,and shorten the rehabilitation time,which is worthy of clinical promotion and application.