钻孔引流和小骨窗开颅治疗高血压基底节区少量脑出血的临床价值

Comparison of the clinical value of drilling drainage and ossicle window craniotomy in the treatment of small amounts of cerebral hemorrhage in the basal ganglia area of hypertension

目的探究钻孔引流和小骨窗开颅治疗高血压基底节区少量脑出血的临床价值。方法选取2018年6月至2020年4月于本院治疗的87例高血压脑出血患者作为研究对象,采取随机数字表法分为对照组(n=43)和观察组(n=44)。对照组应用小骨窗开颅术治疗,观察组应用钻孔引流治疗,比较两组近远期预后指标[美国国立卫生研究院脑卒中量表(NIHSS)、神经功能缺损评分(NFDS)、日常生活能力评定量表(ADL)]及血肿侧相关指标[N-乙酰天门冬氨酸/肌酸(NAA/Cr)、乳酸/肌酸(Lac/Cr)、表观弥散系数(ADC)]。结果术后2周、6个月,观察组NIHSS评分均低于对照组,NFDS、ADL评分均高于对照组,差异有统计学意义(P<0.05);观察组血肿侧的NAA/Cr、Lac/Cr、ADC均明显低于对照组,差异有统计学意义(P<0.05)。结论钻孔引流治疗出血量较少的高血压基底节区脑出血近期及远期预后更佳,与小骨窗开颅治疗相比优势明显,值得临床推广应用。

Objective To investigate the clinical value of drilling drainage and ossicle window craniotomy in the treatment of a small amount of cerebral hemorrhage in the basal ganglia area of hypertension.Methods A total of 87 patients with hypertensive cerebral hemorrhage treated in our hospital from June 2018 to April 2020 were selected as research subjects,and they were divided into control group(n=43)and observation group(n=44)according to random number table method.The control group was treated with ossicle window craniotomy,and the observation group was treated with drilling drainage,and the near and long-term prognostic indicators(National institutes of health stroke scale[NIHSS],neurological deficit score[NFDS],daily living ability rating scale[ADL])and hematoma-side related indicators(N-acetylaspartic acid/creatine[NAA/Cr],lactic acid/creatine[Lac/Cr],apparent diffusion coefficient[ADC])were compared between the two groups.Results 2 weeks after surgery and 6 months,the NIHSS scores in the observation group were lower than those in the control group,and the NFDS and ADL scores were higher than those in the control group,the differences were statistically significant(P<0.05),the NAA/Cr,Lac/Cr and ADC on the hematoma side of the observation group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Drilling and drainage treatment of hypertensive basal ganglia cerebral hemorrhage with less bleeding has better short and long-term prognosis,which has obvious advantages compared with craniotomy,and is worthy of clinical application.