早期微创穿刺引流术治疗高血压性基底节区脑出血的临床效果

Clinical Effect of Early Minimally Invasive Puncture and Drainage in the Treatment of Hypertensive Basal Ganglia Intracerebral Hemorrhage

目的:探讨早期微创穿刺引流术治疗高血压性基底节区脑出血的临床效果。方法:回顾性分析石狮市医院收治的84例高血压性基底节区脑出血患者,病例纳入时间为2020年1-6月。依据患者采用的治疗方案进行分组,其中对照组(n=42)以小骨窗开颅术治疗,观察组(n=42)以微创穿刺引流术治疗。对比两组手术情况、手术结局、神经功能、预后情况。结果:观察组手术时间、住院时间均短于对照组,术后首次进食时间、首次床上活动时间均早于对照组,术中失血量少于对照组(P<0.05)。两组血肿清除率、再出血率、死亡率比较,差异无统计学意义(P>0.05)。术后14 d,观察组美国国立卫生院卒中量表(National Institute of Health stroke scale,NIHSS)评分低于对照组,格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分高于对照组,差异有统计学意义(P<0.05)。观察组预后良好率为88.10%,高于对照组的69.05%,差异有统计学意义(P<0.05)。结论:早期微创穿刺引流术治疗高血压性基底节区脑出血的效果较好,不仅能显著缩短患者的术后恢复时间,并且具有良好的血肿清除效果,对患者神经功能的恢复及预后具有显著的积极作用,应用前景较好。

Objective:To investigate the clinical effect of early minimally invasive puncture and drainage in the treatment of hypertensive basal ganglia intracerebral hemorrhage.Method:A total of 84 patients with hypertensive basal ganglia intracerebral hemorrhage treated in Shishi Hospital were analyzed retrospectively.The cases were included from January to June 2020.The patients were divided into two groups according to the treatment scheme.The control group(42 cases)was treated with small bone window craniotomy,and the observation group(42 cases)was treated with minimally invasive puncture and drainage.The operation,operation outcome,neurological function and prognosis were compared between the two groups.Result:The operation time and the hospital stay in the observation group were shorter than those in the control group,the first postoperative eating time and the first postoperative bed activity time were earlier than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).There was no significant difference in hematoma clearance rate,rebleeding rate and mortality between the two groups(P>0.05).The national institute of health stroke scale(NIHSS)score in the observation group was lower than that in the control group,and the Glasgow coma scale(GCS)score was higher than that in the control group(P<0.05).The good prognosis rate in the observation group was 88.10%,which was higher than 69.05% in the control group,and the difference was statistically significant(P<0.05).Conclusion:Early minimally invasive puncture and drainage is effective in the treatment of hypertensive basal ganglia intracerebral hemorrhage.It can not only significantly shorten the postoperative recovery time,but also have a good effect of hematoma removal.It has a significant positive effect on the recovery of neurological function and prognosis,and has a good application prospect.