经颞部与经额部入路微创钻孔引流术治疗高血压脑出血患者的效果比较

Comparison of effects of minimally invasive drilling and drainage through temporal and frontal approaches in treatment of patients with hypertensive cerebral hemorrhage

目的:比较经颞部与经额部入路微创钻孔引流术治疗高血压脑出血患者的效果。方法:回顾性分析2020年7月至2022年8月该院收治的78例高血压脑出血患者的临床资料,根据手术入路不同将其分为对照组38例和观察组40例。对照组采用经颞部入路微创钻孔引流术治疗,观察组采用经额部入路微创钻孔引流术治疗,比较两组围术期指标水平,手术前后神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]、日常生活能力[日常生活能力量表(ADL)]评分,以及术后7 d并发症发生率。结果:两组手术时间、意识恢复时间、术后7 d血肿残余量和住院时间比较,差异均无统计学意义(P>0.05);观察组术后3 d血肿残余量少于对照组,差异有统计学意义(P<0.05);术后3、6个月,观察组NIHSS评分低于对照组,ADL评分高于对照组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经额部入路微创钻孔引流术治疗高血压脑出血患者可提高ADL评分,降低NIHSS评分,减少术后3 d血肿残余量,效果优于经颞部入路微创钻孔引流术治疗。

Objective:To compare effects of minimally invasive drilling and drainage through temporal and frontal approaches in treatment of patients with hypertensive cerebral hemorrhage.Methods:The clinical data of 78 patients with hypertensive cerebral hemorrhage admitted to the hospital from July 2020 to August 2022 were retrospectively analyzed.According to different surgical approaches,they were divided into control group(38 cases)and observation group(40 cases).The control group was treated with minimally invasive drilling and drainage through temporal approach,while the observation group was treated with minimally invasive drilling and drainage through frontal approach.The perioperative index levels,the scores of neurological deficit[National Institutes of Health stroke scale(NIHSS)]and the daily living ability[activity of daily living scale(ADL)]before and after the surgery,and the incidence of complications 7 days after the surgery were compared between the two groups.Results:There were no significant differences in operation time,consciousness recovery time,residual hematoma volume 7 days after the surgery and hospitalization time between the two groups(P>0.05).The residual volume of hematoma in the observation group was less than that in the control group 3 days after the surgery,and the difference was statistically significant(P<0.05).3 and 6 months after the surgery,the NIHSS scores of the observation group were lower than those of the control group,the ADL scores was higher than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Minimally invasive drilling and drainage through frontal approach can improve the ADL scores,and reduce the NIHSS scores and the hematoma residual volume 3 days after the surgery in the patients with hypertensive cerebral hemorrhage.Moreover,it is superior to minimally invasive drilling and drainage through temporal approach.