基于倾向性评分匹配法评估不同入路手术在基底节区高血压脑出血治疗中的应用效果

Application Effects of Different Approaches in the Treatment of Hypertensive Cerebral Hemorrhage in the Basal Ganglia Based on Propensity Score Matching Method

目的基于倾向性评分匹配法评估不同入路手术在基底节区高血压脑出血(HCH)治疗中的应用效果。方法回顾性收集2018年1月至2021年4月于商丘市长征人民医院接受诊疗的110例基底节区HCH患者的临床资料。其中58例接受经侧裂岛叶入路手术,纳入A组;52例接受经颞叶皮质入路手术,纳入B组。利用倾向性评分分析患者一般资料,采用邻近匹配法进行1∶1匹配,将B组与A组配对,经倾向性评分配比后,最终纳入B组、A组病例各39例。观察两组手术临床指标、血肿清除率、并发症情况。结果A组手术时间[(92.17±13.64)min]短于B组[(99.58±12.36)min],差异有统计学意义(P<0.05);A组血肿清除率优于B组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论经侧裂岛叶入路、经颞叶皮质入路血肿清除术均为临床治疗HCH患者的有效方法,其中经侧裂岛叶入路血肿清除率更高,不会增加术后并发症发生率。

Objective To evaluate the application effect of different approaches in the treatment of hypertensive cerebral hemorrhage(HCH)in the basal ganglia based on propensity score matching method.Methods The clinical data of 110 patients with HCH in basal ganglia treated in Shangqiu Changzheng People’s Hospital from January 2018 to April 2021 were collected,of which 58 cases were operated transsylvian transinsular approach and included in group A,and 52 cases were operated through the temporal cortical approach and included in group B.The general data of patients were analyzed by propensity score,and the adjacent matching method was used for 1∶1 matching,and group B was paired with group A.After propensity score matching,39 cases in group B and 39 cases in group A were finally included.The clinical indexes,hematoma clearance rate and complications of the two groups were observed.Results The operation time in group A[(92.17±13.64)min]was shorter than that in group B[(99.58±12.36)min](P<0.05).The clearance rate of hematoma in group A was better than that in group B(P<0.05).There was no statistical significance in the incidence rates of complications between the two groups(P>0.05).Conclusion Hematoma removal transsylvian transinsular approach or temporal cortical approach are effective methods for the clinical treatment of patients with HCH,the clearance rate of hematoma removal transsylvian transinsular approach is higher,which can’t increase the incidence of postoperative complications.