微创颅内血肿清除术治疗高血压脑出血患者的临床疗效

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目的探讨微创颅内血肿清除术治疗高血压脑出血患者的临床疗效。方法将2013年8月至2016年8月在梅州市人民医院神经外科治疗的84例高血压脑出血患者按随机数字表法分为两组,对照组患者采用开颅去骨瓣减压血肿清除术,观察组采用微创颅内血肿清除术,术后28 d比较两组患者的治疗效果、手术各项指标、血肿及周围水肿改善情况、术后神经功能及生活质量、预后。结果观察组患者治疗总有效率为95.3%,明显高于对照组的80.5%,差异有统计学意义(P<0.05);观察组患者的手术时间、术中出血量与对照组相比差异显著(P<0.05);观察组患者治疗后血肿量及周围水肿量较对照组明显减少,且神经功能缺损评分(NIESS)及日常生活能力BI指数明显较对照组改善,差异均有统计学意义(均P<0.05);观察组患者术后并发症发生率及死亡率均较对照组明显降低,差异均有统计学意义(均P<0.05)。结论微创颅内血肿清除术治疗高血压脑出血患者临床疗效显著,利于血肿的早期消除及神经功能恢复,对患者预后的改善有积极的临床意义。 Objective To investigate the clinical effect of minimally invasive intracranial hematoma in the treatment of patients with hypertensive intracerebral hemorrhage. Methods Eighty-four patients with hypertensive intracerebral hemorrhage treated by neurosurgery in Meizhou People’s Hospital from August 2013 to August 2016 were divided into two groups according to random number table. Patients in the control group were treated with craniotomy decompression hematoma The observation group was treated with minimally invasive intracranial hematoma. At 28 days after operation, the therapeutic effect, the indexes of operation, the improvement of hematoma and surrounding edema, the postoperative neurological function, quality of life and prognosis were compared between the two groups. Results The total effective rate of observation group was 95.3%, which was significantly higher than that of control group (80.5%), the difference was statistically significant (P <0.05). The operation time and intraoperative blood loss in observation group were significantly different from those in control group (P <0.05). The volume of hematoma and the surrounding edema in the observation group were significantly decreased compared with the control group, and the NIESS and BI index of the observation group were significantly improved compared with the control group (P <0.05) P <0.05). The postoperative morbidity and mortality in the observation group were significantly lower than those in the control group (all P <0.05). Conclusion Minimally invasive intracranial hematoma in the treatment of hypertensive intracerebral hemorrhage patients with significant clinical benefit, which will help early elimination of hematoma and neurological recovery, prognosis of patients with a positive clinical significance.
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