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目的比较微创穿刺引流术与小骨窗开颅血肿清除术治疗高血压脑出血(HICH)的临床疗效。方法选择2012年3月至2016年3月收治的360例HICH患者,其中210例行微创穿刺引流术治疗为A组,150例行小骨窗开颅血肿清除术治疗为B组;观察比较两组术后并发症、血肿残留及再出血的发生情况,同时采用美国国立卫生研究院卒中量表(NIHSS)反映患者近期神经功能缺损好转情况,以及采用日常生活活动能力(ADL)分级标准反映患者近期生活状态。结果两组的并发症与血肿残留的发生率比较差异无统计学意义(P均>0.05),B组再出血的发生率显著低于A组(P<0.05);两组术后NIHSS评分均较术前明显降低(P均<0.01),但组间比较无统计学意义(P均>0.05);两组术后ADL分级比较无统计学差异(P均>0.05),但B组的死亡率明显低于A组(P<0.05)。结论微创穿刺引流术与小骨窗开颅血肿清除术均是治疗HICH的有效选择,均可恢复患者神经功能、改善患者日常生活能力,但二者各有优缺点,临床医生应根据患者的适应证并结合实际情况正确抉择。
Objective To compare the clinical effects of minimally invasive puncture drainage and small craniotomy hematoma in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods A total of 360 patients with HICH who were treated from March 2012 to March 2016 were selected. 210 patients underwent minimally invasive puncture and drainage for group A and 150 patients undergoing craniotomy and craniotomy for group B. The postoperative complication, hematoma residue and rebleeding were analyzed. The National Institutes of Health Stroke Scale (NIHSS) was used to reflect the recent improvement of neurological deficits and the level of ADL was used to reflect the patients’ Recent living conditions. Results There was no significant difference in the incidence of complications between two groups (P> 0.05), and the incidence of rebleeding in group B was significantly lower than that in group A (P <0.05). The postoperative NIHSS scores (P <0.01), but there was no significant difference between the two groups (P> 0.05). There was no significant difference in postoperative ADL classification between the two groups (P> 0.05), but the death in group B The rate was significantly lower than the A group (P <0.05). Conclusion Minimally invasive puncture drainage and craniotomy of small bone window craniotomy are all effective options for the treatment of HICH, both of which can restore the neurological function of patients and improve the daily living ability of patients. However, both of them have their own advantages and disadvantages. Clinicians should adapt their patients’ Card and the correct choice of the actual situation.