微创双靶点穿刺引流和开颅手术治疗基底节区高血压脑出血的效果比较

Comparison of Minimally Invasive Double-target Puncture Drainage and Craniotomy Hematoma Evacuation in the Treatment of Hypertensive Cerebral Hemorrhage in Basal Ganglia

目的:分析比较微创双靶点穿刺引流术与开颅血肿清除术治疗基底节区高血压脑出血的效果。方法:回顾性分析2018年8月-2021年1月贵阳市第二人民医院收治的92例基底节区高血压脑出血临床资料。根据手术方式进行分组:开颅组行显微镜下开颅血肿清除术(n=40),微创组行微创双靶点穿刺引流术(n=52)。比较两组手术时间、术中出血量、住院时间、术后并发症及预后情况。结果:微创组手术时间、住院天数均短于开颅组,术中出血量少于开颅组,并发症发生率及肺部感染发生率均低于开颅组,差异均有统计学意义(P<0.05)。术后3个月微创组NIHSS评分和mRS评分均低于开颅组,差异均有统计学意义(P<0.05)。术后1、3个月,微创组Barthel指数评分均高于开颅组,差异均有统计学意义(P<0.05)。结论:微创双靶点穿刺引流术治疗基底节区高血压脑出血效果优于开颅组,有利于患者神经功能恢复,并改善预后。

Objective:To analyze and compare the efficacy of minimally invasive double-target puncture drainage and craniotomy hematoma evacuation in the treatment of hypertensive cerebral hemorrhage in basal ganglia.Method:The clinical data of 92 patients with basal ganglia hypertensive intracerebral hemorrhage admitted to the Second People’s Hospital of Guiyang from August 2018 to January 2021 were retrospectively analyzed.The patients were divided into two groups according to the surgical methods:craniotomy group underwent craniotomy hematoma evacuation (n=40),and minimally invasive group underwent minimally invasive double-target puncture drainage (n=52).The operation time,intraoperative blood loss,hospital stay,postoperative complications and prognosis were compared between two groups.Result:The operation time and hospital stay of the minimally invasive group were shorter than those of the craniotomy group,the intraoperative blood loss of the minimally invasive group was less than that of the craniotomy group,and the incidence of complications and pulmonary infection of the minimally invasive group were lower than those of the craniotomy group,the differences were statistically significant (P<0.05).At 3 months after operation,the NIHSS score and mRS score of the minimally invasive group were lower than those of the craniotomy group,the differences were statistically significant (P<0.05).At 1 month and 3 months after operation,the Barthel index scores of minimally invasive group were higher than those of craniotomy group,the differences were statistically significant (P<0.05).Conclusion:Minimally invasive double-target puncture drainage is superior to craniotomy hematoma evacuation in the treatment of hypertensive cerebral hemorrhage in basal ganglia,which is beneficial to the recovery of neurological function and the improvement of prognosis.