超早期微创穿刺引流术对基底节区脑出血的疗效及其机体功能的影响  

RESEARCH ON THE EFFICACY OF ULTRA-EARLY MINIMALLY INVASIVE SURGERY FOR DRAINAGE OF CEREBRAL HEMORRHAGE IN BASAL GANGLIA AND ON THE EFFECTS OF BODY FUNCTION

作　　者：金涛 王超[2] 

机构地区：[1]辽宁省盘锦市中心医院神经外科,124000 [2]辽宁医学院附属第一医院神经外科二病区

出　　处：《中国煤炭工业医学杂志》2015年第4期517-521,共5页Chinese Journal of Coal Industry Medicine

基　　金：辽宁省自然科学基金项目(No.201102140)

摘　　要：目的探讨超早期微创穿刺引流手术对于基底节区脑出血患者的临床疗效及其对机体功能的影响。方法将81例经CT及病理学诊断为基底节区脑出血患者按照治疗方式随机地分为对照组(n=38)与观察组(n=43),对照组采用常规保守治疗,观察组采用超早期微创穿刺引流手术治疗。比较二组临床疗效、血肿清除相关指标、治疗前后神经功能缺损评分(NIHSS)、日常生活能力(ADL)指数及卡氏评分(KPS)活动指数变化情况、治疗前后白介素6(IL-6)及转化生长因子-β1(TGF-β1)水平变化、不良反应发生情况。结果 1经治疗,对照组临床总有效率为73.68%,显著小于观察组(93.02%)(P<0.05);2二组首次抽血量、留置针时间及血肿完全吸收时间差异均具有统计学意义(P<0.05,P<0.01);3二组治疗前后NIHSS评分、ADL及KPS指数差异均具有统计学意义(P<0.05,P<0.01),且二组治疗后上述指标差异也均具有统计学意义(P<0.05);4二组治疗前后IL-6及TGF-β1水平差异均具有统计学意义(P<0.05,P<0.01),且二组治疗后上述指标差异也均具有统计学意义(P<0.05);5观察组再出血率为2.32%,显著小于对照组(13.16%)(P<0.05)。结论与常规保守治疗方式比较,超早期微创穿刺引流手术对于基底节区脑出血患者的临床疗效更显著,安全性更高,可作为临床治疗基底节区脑出血的有效术式。Objective To investigate the clinical efficacy of ultra-early minimally invasive surgical drainage for patients with basal ganglia hemorrhage and its effect on the body＇s functions.Methods Totally 81 cases of brain hemorrhage basal ganglia patients diagnosed by CT and pathologic method were randomly divided into the control group （n=38）and observation group （n=43）in accordance with treatment method,and the control group received conventional conservative treatment,while the observation group received ultra-early invasive puncture and drainage surgery.Before and after treatment,the clinical efficacy,hematoma related indicators,neurological deficit score （NIHSS）,activities of daily living （ADL）index and Karnofsky score （KPS）activity index changes,changes of interleukin-6 （IL-6）and transforming growth factor -β1 （TGF-β1）levels,the incidence of adverse reactions were compared between the two groups.Results After treatment,the clinical total effective rate was 73.68% in the control group,significantly lower than in the observation group （93.02%）（P 〈0.05）.The first two sets of blood volume,catheter time and time of hematoma completely absorbed were statistically difference （P 〈 0.05,P 〈 0.01 ）between the two groups.Before and after treatment,the differences of two groups in NIHSS score,ADL and KPS index, TGF-β1 and IL-6 levels were statistically significant （P 〈0.05,P 〈0.01）,even if after treatment,these indicators were also differences （P 〈0.05）.The rebleeding rate of the observation group was 2.32%,sig-nificantly lower than those of the control group （13.16%）（P 〈0.05）.Conclusion Compared with con-ventional conservative treatment,the clinical efficacy of ultra- early minimally invasive surgical drainage for patients with basal ganglia hemorrhage is more significant,more secure.It is an effective surgical pro-cedure in the clinical treatment of basal ganglia hemorrhage.

关 键 词：基底节区脑出血 超早期微创穿刺引流手术 安全性 

分 类 号：R743.34[医药卫生—神经病学与精神病学]