钻孔引流与内镜手术治疗脑出血的效果及其对ADL、GOS及NIHSS的影响比较

Comparison of Effect of Trepanation and Drainage and Endoscopic Surgery on Cerebral Hemorrhage and Its Effect on ADL,GOS and NIHSS

目的对比研究脑出血患者采取钻孔引流术与内镜下血肿清除术治疗对患者神经功能与生活质量的影响。方法选取2018年1月—2021年12月于张家港市第一人民医院接受治疗的66例脑出血患者的临床资料进行回顾性分析,根据手术方式分为观察组与对照组,各33例。对照组采取钻孔引流术治疗,观察组实施内镜下血肿清除术治疗,记录对比两组患者手术用时、术中出血量及血肿清除率情况,治疗前后神经损伤(NIHSS)、日常生活能力(ADL)、预后评分(GOS)、TNF-α、PCT、ET-1、NSE指标水平变化。结果观察组患者血肿清除率(93.14±5.29)%高于对照组,术中出血量(35.45±5.96)mL少于对照组,差异有统计学意义(t=9.986、9.941,P<0.05);手术用时(63.38±12.05)min与对照组比较,差异无统计学意义(P>0.05)。术后,观察组NIHSS得分(8.13±1.02)分低于对照组,ADL、GOS得分均高于对照组,差异有统计学意义(P<0.05)。观察组患者术后TNF-α、PCT、ET-1、NSE水平均低于对照组,差异有统计学意义(P<0.05)。结论临床治疗脑出血疾病首选内镜下血肿清除术方案,在提高血肿清除率的基础上,能促进患者神经功能的恢复,提高生活能力。

Objective To compare the effects of trepanation and drainage and endoscopic hematoma removal on neurological function and quality of life in patients with cerebral hemorrhage.Methods A retrospective analysis was conducted on the clinical data of 66 patients with cerebral hemorrhage who received treatment at the First People's Hospital of Zhangjiagang City from January 2018 to December 2021.They were divided into an observation group and a control group based on the surgical method,with 33 patients in each group.The control group was treated with trepanation and drainage,and the observation group was treated with endoscopic hematoma removal.Recorded and compared the operation time,intraoperative bleeding volume,hematoma clearance rate,nerve injury(NIHSS),ability of daily living(ADL),prognosis score(GOS),and changes in the levels of TNF-α,PCT,ET-1,and NSE indicators of the two groups of patients before and after treatment.Results The hematoma clearance rate(93.14±5.29)% in observation group was higher than that in control group,the intraoperative blood loss(35.45±5.96)mL was less than that in control group,the difference was statistically significant(t=9.986,9.941,P<0.05),and the operative time(63.38±12.05)min compared with control group,the difference was not statistically significant(P>0.05).After surgery,the NIHSS score(8.13±1.02)points in the observation group was lower than that in the control group,and the ADL and GOS scores were higher than those in the control group,the difference was statistically significant(P<0.05).Postoperative TNF-α,PCT,ET-1 and NSE in observation group were lower than those in control group,the difference was statistically significant(P<0.05).Conclusion Endoscopic hematoma removal is the first choice for clinical treatment of cerebral hemorrhage diseases.On the basis of improving the hematoma clearance rate,it can promote the recovery of neurological function and improve the life ability of patients.