急诊微创穿刺引流术在高血压脑出血患者神经功能恢复中的应用价值

Application value of emergency minimally invasive puncture drainage surgery in the recovery of neurological function in patients with hypertensive intracerebral hemorrhage

目的 分析急诊微创穿刺引流术在高血压脑出血(HICH)患者神经功能恢复中的应用价值。方法 回顾性分析2017年8月至2021年8月收治的80例HICH患者,根据手术方式不同将其分为对照组(40例,开颅血肿清除术)和研究组(40例,急诊微创穿刺引流术)。比较两组的治疗效果。结果 治疗15 d后,研究组的美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,简易智能精神状态量表(MMSE)评分高于对照组(P<0.05)。治疗1周后,研究组的血肿面积小于对照组(P<0.05)。治疗1周后,研究组的平均血流速度(V_(mean))、平均血流量(Q_(mean))、压力差(DP)、外周阻力(R)、临界压力(CP)、脉搏波速(Wv)优于对照组(P<0.05)。治疗后4个月,研究组的健康调查简表(SF-36)各维度评分及总分高于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论 急诊微创穿刺引流术能有效改善HICH患者神经功能及精神状态,有利于促进术后恢复。

Objective To analyze the application value of emergency minimally invasive puncture drainage surgery in the recovery of neurological function in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 80 patients with HICH admitted from August 2017 to August 2021 were retrospectively analyzed and divided into control group(40 cases,craniotomy hematoma evacuation)and study group(40 cases,emergency minimally invasive puncture drainage surgery)according to different surgical methods.The therapeutic effects of the two groups were compared.Results After 15 d of treatment,the National Institutes of Health Stroke Scale(NIHSS)score of the study group was lower than that of the control group,and the Mini-Mental State Examination(MMSE)score was higher than that of the control group(P<0.05).After 1 week of treatment,the hematoma area of the study group was smaller than that of the control group(P<0.05).After 1 week of treatment,the mean blood flow velocity(V_(mean)),mean blood flow(Q_(mean)),differential pressure(DP),peripheral resistance(R),critical pressure(CP)and wave velocity(Wv)in the study group were better than those in the control group(P<0.05).At 4 months after treatment,the scores of each dimension and total score of the 36-Item Short Form Health Survey(SF-36)in the study group were higher than those in the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion Emergency minimally invasive puncture drainage surgery can effectively improve the neurological function and mental state of HICH patients,which is conducive to promoting postoperative recovery.