方体定向置管血肿穿刺引流术治疗小量高血压壳核出血的临床效果

Clinical outcomes of cubic oriented stereotactic catheterization hematoma puncture drainage in the treatment of small hypertensive putaminal hemorrhage

目的探讨方体定向置管血肿穿刺引流术与保守治疗在小量高血压壳核出血中的临床效果。方法选取112例小量高血压壳核出血患者,根据非随机临床同期对照研究及患者自愿原则将其分为方体定向置管血肿穿刺引流术组(微创组)和内科保守治疗组(保守组)。比较2组患者血肿清除率、神经功能恢复情况、日常活动能力、预后及术后并发症发生情况。结果微创组血肿清除情况优于保守组(P<0.05)。术后1周微创组美国国立卫生院卒中量表(NIHSS)评分低于保守组(P<0.05),格拉斯哥昏迷评分(GCS)高于保守组(P<0.05)。微创组术后并发症发生率低于保守组(P<0.05)。术后6个月微创组日常生活活动能力量表(ADL)评分、格拉斯哥预后评分(GOS)均高于保守组(P<0.05)。结论对小量高血压壳核出血患者给予方体定向置管血肿穿刺引流术治疗效果较好,能有效提高血肿清除率,减轻神经功能损伤,减少术后并发症,有利于患者预后的改善及术后日常生活能力的提高。

Objective To investigate the clinical outcomes of cubic oriented stereotactic catheterization hematoma puncture drainage and conservative treatment for small hypertensive putaminal hemorrhage.Methods A total of 112 patients with small hypertensive putaminal hemorrhage were selected,and they were divided into the cubic oriented stereotactic catheterization hematoma puncture drainage group(the minimally invasive group)and the conservative treatment group(the conservative group)according to the non-randomized clinical concurrent controlled study and patients’voluntary principle.The hematoma clearance rate,recovery of neurological function,activity of daily living,prognosis and occurrence of postoperative complications were compared in the two groups.Results The hematoma clearance of the minimally invasive group was better than that of the conservative group(P<0.05).The national institutes of health stroke scale(NIHSS)score 1 week after operation in the minimally invasive group was lower than that in the conservative group(P<0.05),and the Glasgow coma scale(GCS)was higher than that in the conservative group(P<0.05).The incidence of postoperative complications in the minimally invasive group was lower than that in the conservative group(P<0.05).The activities of daily living(ADL)score and Glasgow outcome scale(GOS)6 months after operation of the minimally invasive group were higher than those of the conservative group(P<0.05).Conclusion The cubic oriented stereotactic catheterization hematoma puncture drainage has a good therapeutic effect on patients with small hypertensive putaminal hemorrhage,which can effectively improve the hematoma clearance rate,alleviate the neurological impairment and reduce the postoperative complications,thereby improving the prognosis and activities of daily living after operation.