CT定位辅助下微创穿刺引流术对高血压脑出血患者神经功能缺损评分与并发症发生情况的影响

The effect of CT assisted minimally invasive puncture and drainage on neurological deficits and incidence of complications in patients with hypertensive intracerebral hemorrhage

目的探讨CT定位辅助下微创穿刺引流术对高血压脑出血(HICH)患者神经功能缺损评分与并发症发生情况的影响。方法选取2019年1月至2022年3月昌邑市人民医院收治的96例HICH患者作为研究对象,按照奇偶数法分为A组与B组,每组48例。A组行CT定位辅助下微创穿刺引流术治疗,B组行小骨窗开颅血肿清除术治疗,比较两组基本手术指标、神经功能损伤程度[神经功能缺损评分(NFDS)]及日常生活能力[Barthel指数评定量表(BI)]、生命质量[脑卒中影响量表(SIS)]、血管内皮功能[一氧化氮(NO)、内皮素-1(ET-1)]、并发症发生情况、不良事件发生情况。结果A组术中出血量少于B组,住院时间短于B组,血肿清除率高于B组,差异有统计学意义(P<0.05)。治疗后,两组NFDS评分均低于治疗前,BI评分均高于治疗前,且A组NFDS评分低于B组,BI评分高于B组,差异有统计学意义(P<0.05)。治疗后,两组交流、日常生活能力、移动能力、情感、参与、力气、手功能、记忆与思维评分均高于治疗前,且A组高于B组,差异有统计学意义(P<0.05)。治疗后,两组NO水平均高于治疗前,ET-1水平均低于治疗前,且A组NO水平高于B组,ET-1水平低于B组,差异有统计学意义(P<0.05)。A组并发症发生率低于B组,差异有统计学意义(P<0.05)。两组不良事件发生率比较差异无统计学意义。结论CT定位辅助下微创穿刺引流术疗效更佳,可有效减轻患者神经功能损伤,减少并发症发生,值得临床推广应用。

Objective To explore the effect of CT assisted minimally invasive puncture and drainage on neurological deficits and incidence of complications in patients with hypertensive intracerebral hemorrhage(HICH).Methods 96 HICH patients admitted to Changyi People's Hospital from January 2019 to March 2022 were selected as the research subjects,they were divided into the group A and the group B according to the odd even method,with 48 cases in each group.Group A was treated with CT assisted minimally invasive puncture and drainage,and group B was treated with small bone window craniotomy hematoma removal,the basic surgical indicators,degree of neurological damage(neurofunctional deficiency score[NFDS]),daily living ability(Barthel index[BI]),quality of life(stroke impact scale[SIS]),vascular endothelial function(nitric oxide[NO],endothelin-1[ET-1]),occurrence of complications and adverse events were compared between the two groups.Results The intraoperative bleeding in the group A was less than that in the group B,the hospital stay was shorter than that in the group B,and the hematoma clearance rate was higher than that in the group B,and the differences were statistically significant(P<0.05).After treatment,the NFDS scores of the two groups were lower than before treatment,and the BI scores were higher than before treatment,and the NFDS scores in the group A was lower than that in the group B,and the BI scores was higher than that in the group B,and the differences were statistically significant(P<0.05).After treatment,the communica-tion,daily living ability,mobility,emotion,participation,strength,hand function,memory,and thinking scores of the two groups were higher than be-fore treatment,and the group A was higher than the group B,and the differences were statistically significant(P<0.05).After treatment,the NO lev-els of the two groups were higher than before treatment,and the ET-1 levels was lower than before treatment,and the NO levels in the group A was higher than that in the group B,and the ET-1 levels was lower than that in the group B,and the differences were statistically significant(P<0.05).The incidence of complications in the group A was lower than that in the group B,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups.Conclusion CT assisted minimally invasive puncture and drainage surgery has better therapeutic effect,can effectively reduce neurological damage in patients,reduce the occurrence of compli-cations,and is worthy of clinical promotion and application.