开颅手术与改良-立体定向软通道穿刺引流术治疗脑出血的疗效和安全性研究

Efficacy and safety of modified stereotactic soft channel puncture and drainage in treatment of cerebral hemorrhage

目的探讨改良-立体定向软通道穿刺引流术治疗脑出血的疗效和安全性。方法将徐州医科大学附属邳州医院2018年4月—2021年4月收治的80例脑出血患者,随机分为观察组和对照组,各40例。对照组行开颅血肿清除术,观察组行改良-立体定向软通道穿刺引流术。观察两组血肿清除情况、临床疗效、美国国立卫生研究院卒中量表(NIHSS)和日常生活活动能力评定量表(ADL)评分、并发症的发生率;比较两组术前和手术6个月后NIHSS评分和ADL评分。结果与对照组(65.00%、15.00%)相比,观察组血肿清除80%~100%的患者比例(82.50%)明显增加,血肿清除50%(2.50%)的患者显著下降(P<0.05),两组比较差异无统计学意义(P>0.05);与对照组(80.00%)相比,观察组临床总有效率(97.50%)明显高于对照组(P<0.05);与术前比较,两组术后6个月NIHSS评分较术前明显下降,ADL评分较术前明显升高。观察组变化幅度明显大于对照组(P<0.05);与对照组(37.50%)相比,观察组并发症发生率(22.50%)显著降低(P<0.05)。结论改良-立体定向软通道穿刺术治疗脑出血安全有效,具有并发症少、住院时间短等优点,具有较高的临床参考价值。

Objective To investigate the efficacy and safety of modified stereotactic soft channel puncture and drainage in the treatment of intracerebral hemorrhage.Methods 80 patients with cerebral hemorrhage treated in Pizhou Hospital affiliated to Xuzhou Medical University from April 2018 to April 2021 were randomLy divided into observation group(n=40)and control group(n=40).Craniotomy was performed in the control group,and stereotactic soft channel puncture and drainage was performed in the observation group.The hematoma clearance,clinical efficacy,the scores of National Institutes of Health Stroke Scale(NIHSS)and Activities of Daily Living scale(ADL),and the incidence of complications were observed in the two groups,and the NIHSS and ADL scores were compared before and 6 months after operation.Results Compared with the control group(65.00%,15.00%),the percentage of patients with hematoma clearance of 80%~100%in the observation group(82.5%)was significantly higher than that of the control group(65.00%,15.00%),while the proportion of 50%(2.5%)of patients with hematoma clearance in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference between the two groups(P>0.05).Compared with the control group(80.00%),the total clinical effective rate of the observation group(97.50%)was significantly higher than that of the control group(P<0.05).Compared with the preoperative,the NIHSS score of the two groups decreased significantly 6 months after operation,and the ADL score was significantly higher than that before operation.The change range of the observation group was significantly larger than that of the control group(P<0.05),and the incidence of complications in the observation group(22.50%)was significantly lower than that of the control group(37.50%)(P<0.05).Conclusion The modified stereotactic soft channel puncture is safe and effective in the treatment of intracerebral hemorrhage with the advantages of less complications and short hospital stay,and has high clinical reference value.