摘要
目的:探讨微创穿刺血肿引流术(MIPHD)治疗高血压脑出血(HICH)的疗效和安全性。方法:选取HICH患者90例,根据手术方法不同将47例采取MIPHD治疗的患者纳入观察组,43例行小骨窗血肿清除术(SWC)的患者纳入对照组。比较2组患者术后颅内压、临床指标、并发症发生率,观察手术前后神经功能[美国国立卫生研究院卒中量表(NIHSS)]及生活能力(Barthel指数)变化情况。结果:观察组患者术后即时、24 h、5 d颅内压均高于对照组,手术时间、住院时间均短于对照组,首次血肿清除率低于对照组(P﹤0.05);术后14 d,2组患者NIHSS评分较术前降低,Barthel指数较术前升高,且观察组改善程度高于对照组(P﹤0.05);2组患者术后并发症发生率比较差异无统计学意义(P﹥0.05)。结论:MIPHD治疗HICH在首次清除血肿和早期降低颅内压方面不如SWC,但可缩短手术时间和住院时间,更好的改善患者神经功能和生活能力,且不增加并发症。
Objective:To investigate the effects and safety of minimally invasive puncture hematoma drainage(MIPHD)in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods:90 patients with HICH were selected.According to different surgical methods,47 patients treated with MIPHD were included in an observation group,and 43 patients who underwent small bone window hematoma clearance(SWC)were included in a control group.The postoperative intracranial pressure,clinical indicators and incidence rates of postoperative complications were compared between the two groups,and the changes in neurological function[National Institutes of Health Stroke Scale(NIHSS)]and living ability(Barthel index)were observed before and after surgery.Results:The intracranial pressure in the observation group was higher than that in the control group immediately,at 24h and 5d after surgery,the surgical time and hospital stay were both shorter than those in the control group,and the first hematoma clearance rate was lower than that in the control group(P<0.05).14d after surgery,the NIHSS score in the two groups was decreased while the Barthel index was increased compared with pre-operation,indicating more improvement in the observation group than in the control group(P<0.05).There were no significant differences in the incidence rates of postoperative complications between the two groups(P>0.05).Conclusion:MIPHD treatment of HICH is not as good as SWC in first hematoma clearance and early intracranial pressure reduction,but it can shorten the surgical time and hospital stay,better improve the neurological function and living ability of patients without increasing complications.
作者
王峰晓
WANG Feng-xiao(Department of Neurosurgery,The People's Hospital of Xin'an County,Henan 471000,China)
出处
《淮海医药》
CAS
2020年第2期120-122,共3页
Journal of Huaihai Medicine
关键词
颅内出血
高血压性
微创穿刺血肿引流术
小骨窗血肿清除术
Intracerebral hemorrhage,hypertensive
Minimally invasive puncture hematoma drainage
Small bone window hematoma clearanc
