高血压脑内出血开颅血肿清除术与微创钻孔引流术的临床疗效对比

Study on the Curative Effects of Minimally Invasive Trepanation and Drainage and Craniotomy for Scavenging Hematoma in the Treatment of Hypertensive intracerebral Hemorrhage

目的探讨高血压脑内出血(HICH)开颅血肿清除术与微创钻孔引流术的临床疗效的比较。方法选取2008年1月到2013年1月期间到我院神经外科接受治疗的HICH患者120例。其中采用传统开颅血肿清除术对照组患者为60例,采用微创钻孔引流术治疗的观察组患者为60例。比较两组患者术后日常生活能力,神经功能;格拉斯哥预后评分(GOS)以及术后6个月的并发症发生情况。结果两组患者治疗前神经功能缺损评分及ADL评分无显著差异(P>0.05),但术后2周,微创组神经功能缺损评分明显低于开颅组,术后6个月时,微创组ADL评分明显高于开颅组,差异显著(P<0.05),而两组患者GOS评分的伤残情况没有显著差异(P>0.05)。术后并发症观察组显著低于对照组(P<0.05)。结论微创钻孔引流术的临床疗效优于开颅血肿清除术,是治疗HICH的有效方法。

Objective To investigate the effect of minimally invasive trepanation and drainage and craniotomy for scavenging hematoma in the treatment of hypertensive intracerebral hemorrhage( HICH).Methods 120 patients with HICH to our hospital during Dec. 2008 ~ Jan. 2013 were divided into two groups.The 60 patients in research group were treated with minimally invasive trepanation treatment,and the 60 patients in control group were treated with drainage and craniotomy for scavenging hematoma. Compared between the two groups at the activity of daily living scale( ADL),clasgow outcome score( GOS),and postoperative complications. Results There was no significant difference between the two groups before treatment and no significant difference in ADL score( P > 0. 05). The score of nerve function defect of minimally invasive group was significantly lower than that of the craniotomy group( P < 0. 05),and the ADL score of minimally invasive group was significantly higher than that in the craniotomy group,and the difference was significant( P < 0. 05). And there was no significant difference between the two groups with GOS score( P> 0. 05). Postoperative complications in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion Minimally invasive trepanation clinical efficacy is better than drainage and craniotomy for scavenging hematoma,is an effective method for treatment of HICH.