软通道微创穿刺引流术治疗老年高血压脑出血对患者术后神经功能恢复及并发症的影响

Effect of minimally invasive puncture and drainage in the treatment of hypertensive intracerebral hemorrhage in elderly patients on postoperative neurological function recovery and complications

目的探讨软通道微创穿刺引流术治疗老年高血压脑出血对患者术后神经功能恢复、并发症的影响。方法选取2019年2月至2021年1月于上饶市人民医院确诊的60例老年高血压脑出血患者作为研究对象,随机分为观察组与对照组,每组30例,对照组接受开颅血肿清除术,观察组接受软通道微创穿刺引流术。比较两组临床疗效及手术时间、切口长度、住院时间和术后并发症发生情况、术后血肿清除率、术后3个月神经功能缺损程度评分[美国国立卫生研究院卒中量表(NIHSS)]及日常生活活动能力(Barthel指数)。结果观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。观察组手术时间、切口长度及术后住院时间均短于对照组,差异有统计学意义(P<0.05),两组血肿清除率比较差异无统计学意义。观察组并发症发生率为3.33%,低于对照组的20.00%,差异有统计学意义(P<0.05)。术后3个月,两组NIHSS评分低于术前,Barthel指数高于术前,且观察组NIHSS评分低于对照组,Barthel指数高于对照组,差异有统计学意义(P<0.05)。结论与开颅血肿清除术相比较,软通道微创穿刺引流术可更有效促进高血压脑出血老年患者神经功能恢复,减少并发症,提高日常生活能力,且安全性较高。

Objective To investigate the effect of minimally invasive puncture and drainage in the treatment of hypertensive intracerebral hemor-rhage in elderly patients on postoperative neurological function recovery and complications.Methods A total of 60 elderly patients with hyperten-sive intracerebral hemorrhage diagnosed in Shangrao People's Hospital from February 2019 to January 2021 as the study subjects,and they were ran-domly divided into the observation group and the control group,with 30 cases in each group.The control group received craniotomy hematoma re-moval,and the observation group received minimally invasive puncture and drainage.The clinical efficacy,operation time,incision length,hospital-ization time,postoperative complications,postoperative hematoma clearance rate,and National Institute of Health stroke scale(NIHSS)3 months af-ter surgery and activities of daily living(Barthel index)were compared between the two groups.Results The total effective rate in the observation group was 93.33%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05).The operation time,sur-gical incision length and hospitalization time in the observation group were lower than those in the control group,the differences were statistically sig-nificant(P<0.05),and there was no significant difference in the clearance rate of hematoma between the two groups.The incidence of complications in the observation group was 3.33%,which was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).3 months after surgery,the NIHSS score of the two groups were lower than before surgery,and Barthel index was higher than before surgery,and NI-HSS score in the observation group was lower than that in the control group,and Barthel index was higher than that in the control group,the differenc-es were statistically significant(P<0.05).Conclusion Compared with craniotomy and hematoma removal,minimally invasive puncture and drain-age can effectively promote the recovery of nerve function,reduce complications,improve the ability of daily life in elderly patients with hypertensive cerebral hemorrhage,and has high safety.