开颅手术与微创手术治疗脑出血的临床疗效

Clinical effect of craniotomy and minimally invasive surgery on cerebral hemorrhage

目的探讨开颅手术和微创手术治疗脑出血的临床疗效。方法选取2019年5月至2020年10月本院收治的72例脑出血患者作为研究对象,随机分为参照组与实验组,每组36例。参照组行开颅手术进行治疗,实验组行微创手术治疗,比较两组围手术期指标、并发症发生情况、手术前后神经功能缺损情况、术后生命质量情况。结果实验组手术时间、住院时间均短于参照组,术中出血量少于参照组,差异有统计学意义(P<0.05)。两组神经功能评分量表(NIHSS)组间、时间比较差异有统计学意义,两组NIHSS评分交互比较差异无统计学意义。组内比较:两组手术前后各时间点NIHSS评分均低于前一时间点,差异有统计学意义(P<0.05)。组间比较:术前,两组NIHSS评分比较差异无统计学意义;术后7、14 d,实验组NIHSS评分均低于参照组,差异有统计学意义(P<0.05)。实验组并发症发生率为5.56%,低于对照组的30.56%,差异有统计学意义(P<0.05)。实验组社会能力、生理功能、健康状况、躯体疼痛、精神健康评分均高于参照组,差异有统计学意义(P<0.05)。结论应用微创手术治疗脑出血患者疗效确切,有效缩短手术时间和住院时间,减少术中出血量及术后并发症的发生,改善患者神经缺损情况,提高患者生命质量,值得临床推广应用。

Objective To investigate the clinical effects of craniotomy and minimally invasive surgery in the treatment of cerebral hemorrhage.Methods A total of 72 patients with cerebral hemorrhage admitted to our hospital from May 2019 to October 2020 were selected as the research subjects,and they were randomly divided into the control group and the experimental group,with 36 cases in each group.The control group received craniotomy,and the experimental group received minimally invasive surgery,the operation,complications,neurological impairment before and after surgery,and postoperative quality of life were compared between the two groups.Results The operation time and hospital stay in the experimental group were shorter than that in the control group,and the intraoperative blood loss was less than that in the control group,the difference was statistically significant(P<0.05).There were statistically significant differences in National Institute of Health stroke scale(NIHSS)scores between the two groups of the group,time points(P<0.05),but there were no statistically significant differences in NIHSS scores between the two groups of the interaction.Comparison within the group:The NIHSS scores of the two groups were lower than those of the previous time point after operation,and the differences were statistically significant(P<0.05).Comparsion between groups:before operation,there was no significant difference in NIHSS score between the two groups;after 7 and 14 d,NIHSS scores in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).The complication rate in the experimental group was 5.56%,which was lower than 30.56%in the control group,and the difference was statistically significant(P<0.05).The scores of social ability,physiological function,health status,physical pain and mental health in the experimental group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusions Minimally invasive surgery is effective in the treatment of patients with cerebral hemorrhage.It can effectively shorten the operation time and hospital stay,reduce intraoperative blood loss and postoperative complications,improve the neurological defects of patients and improve the quality of life of patients.It is worthy of clinical promotion and application.