糖尿病并发脑出血的神经外科治疗的疗效分析

目的探讨糖尿病并发脑出血的神经外科治疗的疗效。方法回顾性分析2018年2月—2020年2月60例糖尿病并发脑出血患者的临床资料,25例患者接受传统开颅血肿清除术治疗(开颅组),35例患者接受钻孔微创血肿清除术治疗(微创组),比较两组治疗效果。结果微创组治疗后空腹血糖(FPG)为(6.68±0.86)mmol/L,餐后2 h血糖(2 hPG)为(7.55±0.95)mmol/L,糖化血红蛋白(GHb)为(6.47±0.74)%,均低于开颅组(7.50±1.26)mmol/L、(9.63±1.52)mmol/L、(8.93±0.85)%],差异有统计学意义(P<0.05);两组血肿清除率差异无统计学意义(P>0.05);微创组卧床时间为(6.10±1.13)d,住院时间为(15.02±1.84)d,短于开颅组的(8.15±1.20)d与(18.93±2.24)d,差异有统计学意义(P<0.05);微创组术后日常生活能力量表(ADL)评分为(55.72±5.09)分,高于开颅组的(40.85±5.36)分,差异有统计学意义(P<0.05)。结论糖尿病并发脑出血神经外科治疗时钻孔微创血肿清除术可有效快速清除血肿,使患者机体血糖水平得到控制,同时有利于患者术后恢复,提升其日常生活能力。

Analysis of the Therapeutic Effect of Neurosurgical Treatment of Diabetes Complicated with Cerebral Hemorrhage

Objective To explore the efficacy of neurosurgical treatment of diabetes complicated with cerebral hemorrhage.Methods From February 2018 to February 2020,the clinical data of 60 patients with diabetes complicated with cerebral hemorrhage were retrospectively analyzed.25 patients received traditional craniotomy treatment(craniotomy group)and 35 patients received drilling minimally invasive hematoma removal treatment(minimally invasive group),to compare the treatment effects of the two groups.Results The fasting blood glucose(FPG)after treatment in the minimally invasive group was(6.68±0.86)mmol/L,the 2 h postprandial blood glucose(2 hPG)was(7.55±0.95)mmol/L,and the glycosylated hemoglobin(GHb)was(6.47±0.74)%,all lower than the craniotomy group(7.50±1.26)mmol/L,(9.63±1.52)mmol/L,(8.93±0.85)%],the difference was statistically significant(P<0.05);there was no statistically significant difference in hematoma clearance between the two groups(P>0.05);the minimally invasive group’s bedtime was(6.10±1.13)d,and the hospital stay was(15.02±1.84)d,which was shorter than(8.15±1.20)d and(18.93±2.24)d in the craniotomy group.The difference was statistically significant(P<0.05);the postoperative ability of daily living(ADL)score of the minimally invasive group was(55.72±5.09)points,which is higher than the(40.85±5.36)points of the craniotomy group,and the difference was statistically significant(P<0.05).Conclusion In the neurosurgical treatment of diabetes complicated with cerebral hemorrhage,drilling and minimally invasive hematoma removal can effectively and quickly remove the hematoma,control the blood glucose level of the patient,and at the same time help the patient recover after surgery and improve their ability of daily living.