微创颅内血肿清除术治疗高血压脑出血的临床研究

目的研究微创颅内血肿清除术治疗高血压脑出血的临床效果。方法选择我院2014年1月~2017年1月收治的70例高血压脑出血患者作为研究对象,根据治疗方法不同随机分为微创组与对照组,每组各35例,对照组采取传统开颅血肿清除术,微创组行微创颅内血肿清除术,比较两组的治疗效果,以及在手术时间、术中出血量、住院时间及并发症方面的差异。结果治疗后,对照组患者的治愈率为34.4%、无效率为25.7%、总有效率为74.3%,微创组患者的治愈率为40.0%、无效率为5.7%、总有效率为94.3%,微创组患者的治疗效果显著优于对照组,组间比较,差异具有统计学意义(P0.05)。对照组患者在手术时间、术中出血量、住院时间及并发症方面与微创组比较,差异有统计学意义(P0.05),微创组患者的手术时间短、术中出血量少、术后并发症少、住院时间短。对照组与微创组患者术前NIHSS评分差异不显著(P0.05),术后5、15、30 d,对照组与微创组患者NIHSS评分分别较术前显著降低,且微创组患者的NIHSS评分术后5、15、30 d分别显著低于对照组,差异有统计学意义(P0.05)。结论微创颅内血肿清除术治疗高血压脑出血临床效果确切,手术时间短、术中出血量少、术后并发症少、住院时间短、血肿清除率高、神经功能改善明显,是目前治疗高血压脑出血的一种简易、安全、有效的方法。

Clinical study of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage

Objective To study the clinical effect of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage.Methods A total of 70 patients with hypertensive intracerebral hemorrhage in our hospital from Jan 2014 to Jan 2017 were selected as the research subjects.According to different treatment methods,the patients were randomly divided into minimally invasive group and control group,with 35 patients in each group.The control group was given traditional craniotomy evacuation of hematoma,and the minimally invasive group was given minimally invasive intracranial hematoma evacuation.The differences of therapeutic effect,as well as the operation time,intraoperative blood loss,length of stay and complications were compared between the two groups.Results After treatment,the cure rate in the control group was 34.4%,the inefficiency rate was 25.7%,and the total effective rate was 74.3%.The cure rate in the minimally invasive group was 40.0%,the inefficiency rate was 5.7%,and the total effective rate was 94.3%.The therapeutic effect in the minimally invasive group was significantly better than that in the control group,and the difference between two groups was significant(P<0.05).There were significant differences between the two groups in the operation time,the amount of bleeding during surgery,the length of stay and complications(P<0.05).In the minimally invasive group,the operation time was shorter,the intraoperative blood loss was less,the postoperative complications were fewer,and the length of stay was shorter.There was no significant difference in NIHSS score between the control group and the minimally invasive group(P>0.05).5,15,30 days after operation,the NIHSS scores in both groups were significantly lower than those before surgery.The NIHSS scores in the minimally invasive group were significantly lower than those in the control group at 5,15,and 30 days after operation(P<0.05).Conclusion The minimally invasive intracranial hematoma evacuation is effective in the treatment of hypertensive intracerebral hemorrhage.The operation time is shorter,the intraoperative blood loss is less,the postoperative complications are fewer,the length of stay is shorter,the hematoma removal rate is higher,and the neurological function is improved obviously.It is currently a simple,safe and effective method in the treatment of hypertensive intracerebral hemorrhage.