比较内镜下“小天窗”血肿清除术与钻孔引流术治疗高血压脑出血的疗效分析

Comparison of the Efficacy of Endoscopic"Small Skylight"Hematoma Evacuation and Burr Hole Drainage in the Treatment of Hypertensive In⁃tracerebral Hemorrhage

目的对比高血压脑出血应用内镜下“小天窗”血肿清除术与钻孔引流术的有效性。方法选取2019年1月—2020年12月陇南市第一人民医院收治的50例高血压脑出血患者,根据不同手术方式分为内镜组(25例)与钻孔组(25例),对比两组的治疗效果。结果内镜组患者的手术时间(89.35±11.54)min长于钻孔组(34.27±5.92)min、住院时间(11.24±3.54)d短于钻孔组(14.92±3.49)d、术中出血量(48.24±7.56)mL多于钻孔组(10.77±3.26)mL、术后3 d血肿清除率(89.57±4.51)%高于钻孔组(68.93±6.49)%,差异有统计学意义(t=21.234、3.701、22.756、13.058,P<0.05);两组患者在消化道出血、再出血、死亡方面差异无统计学意义(χ^(2)=0.189、0.272、0.000,P=0.663、0.602、1.000);内镜组的颅内感染与肺内感染发生率相比于钻孔组低,差异有统计学意义(χ2=4.735、4.878,P=0.030、0.027);两组患者的NIHSS评分、ADL评分与GOS评分差异无统计学意义(P>0.05)。结论高血压脑出血患者接受内镜下“小天窗”血肿清除术的有效性更优。

Objective To compare the effectiveness of endoscopic"small skylight"hematoma evacuation and burr hole drainage for hypertensive intracerebral hemorrhage.Methods 50 patients with hypertensive intracerebral hemorrhage in the Longnan First People′s Hospital from January 2019 to December 2020 was selected.According to different surgical methods,the patients were divided into endoscopic group(25 cases)and drilling group(25 cases)to compared the therapeutic effect.Results In the endoscopic group,the operation time was(89.35±11.54)min longer than drilling group(34.27±5.92)min,hospital time(11.24±3.54)d shorter than drilling group(14.92±3.49)d,intraoperative bleeding(48.24±7.56)mL more than drilling group(10.77±3.26)mL,3 d postoperative hematoma clearance(89.57±4.51)%higher than drilling group(68.93±6.49)%,and the difference was statistically significant(t=21.234,3.701,22.756,13.058,P<0.05);there was no statistically significant difference in gastrointestinal bleeding,rebleeding,and death between the two groups(χ^(2)=0.189,0.272,0.000,P=0.663,0.602,1.000);the incidence of intracranial infection and intrapulmonary infection in the endoscopic group was lower than that of the drilling group,and the difference was statistically significant(χ^(2)=4.735,4.878,P=0.030,0.027);there was no statistically significant difference in the NIHSS,ADL and GOS scores between the two groups of patients(P>0.05).Conclusion The efficacy of endoscopic"small skylight"hematoma evacuation in patients with hypertensive intracerebral hemorrhage is better.