早期微创穿刺与小骨窗开颅血肿清除术治疗高血压脑出血的疗效分析

【摘要】〓目的〓比较早期微创穿刺引流术与小骨窗血肿清除术治疗基底节区高血压脑出血的临床疗效。方法〓回顾性分析98例高血压性基底节区脑出血患者临床资料,根据资料,按不同的手术方法分为微创穿刺引流术(微创组,n=63例)和小骨窗开颅血肿清除术(小骨窗组,n=35例),评价两组患者手术和住院时间、意识障碍恢复时间、治疗1个月时神经功能缺损程度(NID)和3个月时日常生活活动能力(ADL)。结果〓微创组手术时间和住院天数显著短于小骨窗组,意识恢复时间无显著性差异;而1个月后微创组患者的NID明显低于小骨窗组(P<0.05);治疗3个月后随访,患者ADL达自理水平的较好状态者(Barthel指数≥80),两组有显著性差异(P<0.05),微创组优于小骨窗组。结论〓与小骨窗组相比,微创穿刺术可明显缩短高血压基底节区脑出血患者的手术时间和住院时间,,改善神经功能缺失程度。

Comparison of the therapeutic effect between early minimally invasive craniopuncture drainage and small bone flap craniotomy for removing the hematoma in hypertensive cerebral hemorrhage

ObjectiveTo evaluate the curative effect between early minimally invasive craniopuncture drainage and small bone flap craniotomy for removing the hematoma in hypertensive cerebral hemorrhage. MethodsThe clinical data of 98 patients with hypertensive basal ganglia hemorrhage were retrospectively analyzed. The patients were divided into minimally invasive hematoma removal surgery group （minimally invasive group, n=63 cases） and small bone flap craniotomy hematoma removal group （small bone flap craniotomy group, n=35 cases）. Operation time, hospitalization stay and awareness recovery of patients were evaluated. The neurologic deficit （NID） and the activities of daily living （ADL） were measured at 1 and 3 months after operation respectively. ResultsThe operation time and hospitalization stay in minimally invasive group were less than that in small bone flap craniotomy group. No statistical difference was observed in the time of awareness recovery of patients between two groups. One month after treatment, the NID of minimally invasive group was significantly lower than that of the small bone flap craniotomy group. The patient self-care ADL of minimally invasive group was better than that of the small bone flap craniotomy group at the third month. ConclusionMinimally invasive puncture has an advantage over small bone flap craniotomy in the operation time, hospitalization stay, reduction of neurological deficit and recovery of daily living activities.