CT引导下颅内血肿微创清除术治疗高血压性脑出血的临床研究

目的探讨CT引导下颅内血肿微创清除术治疗高血压性脑出血的疗效。方法选择101例中重度血压性脑出血患者,随机分为2组,微创组48例行常规保守治疗加微创颅内血肿清除术,保守组53例仅行保守治疗。比较2组疗效、血肿消失速度和治疗后15 d神经功能缺损评分。结果微创组显效率38%,总有效率65%,保守组分别为15%和40%,2组比较有显著性差异(P均<0.01);微创组病死率为23%,保守组为45%,2组比较有显著性差异(P<0.01);微创组血肿完全消失(16.2±3.6)d,保守组为(41.3±5.2)d,2组比较有显著性差异(P<0.01);治疗15 d后2组神经功能缺损评分比较有显著性差异(P<0.01)。结论颅内血肿微创清除术治疗高血压性脑出血能有效降低病死率,加快血肿清除,促进神经功能恢复。

Clinical study of microinvasive evacuation by CT-guided on Hypertensive Intracerebral Hemorrhage

Objective It is to observe the effects of microinvasive evacuation by CT-guided on Hypertensive Intracerebral Hemorrhage.Methods 101 patients with Hypertensive Intracerebral Hemorrhage were chosen and divided into two groups: 48 cases in microinvasive group were treated by microinvasive evacuation combined with internal medicine conservative treatment,and 53 cases in conservative group were treated by internal medicine conservative treatment only.The curative effect,the haematoma vanishing speed and the clinical neurological impairment scores(CNIS) 15 days latter were observed and compared each other in both groups.Results The excellence rate and total effective rate was 38% and 65% separately in microinvasive group,and was 15% and 40% in conservative group.There were significance differences between both groups(P<0.01).The mortalities was 23% in microinvasive group,and was 45% in conservative group,there was significance in them(P<0.01).The time of vanish average in microinvasive group was (16.2±3.6) days,it was faster obviously than conservative group((41.3±5.2) days)(P<0.01).There was significance difference in CNIS between the two groups after treated for 15 days(P<0.01).Conclusion Microinvasive evacuation can enhance effectiveness obviously,reduce the mortality,speed up the haematoma to eliminate,promote nerve function restoration in treating Hypertensive Intracerebral Hemorrhage.