早期微孔手术与内科保守治疗对中小量基底节脑出血后脑水肿及预后的影响  

Effect of Early Endoscopic Surgery and Conservative Treatment on Brain Edema and Prognosis in Patients with Small Amount of Basal Ganglia Hemorrhage

作　　者：浦志一[1] PU Zhi-yi(Department of Cerebral Surgery,People’s Hospital of Baoying County,Baoying,Jiangsu Province,225800 China)

机构地区：[1]江苏省宝应县人民医院脑外科,江苏宝应225800

出　　处：《系统医学》2017年第21期75-78,共4页Systems Medicine

摘　　要：目的比较早期微孔手术与内科保守治疗中小量基底节脑出血后脑水肿的临床疗效及对患者预后的影响。方法选择该院2014年3月—2017年2月收治的中小量基底节脑出血患者96例,随机分为保守组与手术组,每组48例。保守组采用内科保守方法进行治疗,手术组采用早期微孔手术进行治疗。比较两组治疗前、治疗后3 d以及治疗后14 d的血肿水肿体积,并用美国国立卫生研究院卒中量表(NIHSS)、日常生活能力表Barthel指数(BI)比较两组上述时间点的神经功能。结果治疗后3 d以及治疗后14 d,手术组和保守组血肿水肿体积分别为[(8.45±1.55)、(2.03±0.47)、(13.51±2.78)、(5.97±1.13)mL],均明显低于治疗前的[(26.43±6.17)、(26.38±5.86)mL],且手术组降低较保守组更加显著,差异有统计学意义(P<0.05);治疗后3 d以及治疗后14 d,手术组和保守组患者的NIHSS分别为[(15.45±3.68)分、(7.93±2.37)分、(23.21±4.68)分、(9.49±2.24)分],均明显低于治疗前组的[(31.25±5.19)分、(31.29±5.06)分],BI评分分别为[(48.57±6.87)分、(61.47±9.42)分、(39.46±5.77)分、(50.31±6.78)分],均明显高于治疗前的[(27.63±4.52)分、(27.58±4.87)分],且手术组较对照组更加显著,差异有统计学意义(P<0.05)。结论与内科保守治疗比较,早期微孔手术治疗中小量基底节脑出血后脑水肿可以明显的减轻患者的脑水肿程度,改善患者的神经功能。Objective This paper tries to compare the clinical efficacy and prognosis of early micropore surgery and medical conservative treatment of cerebral edema after a small amount of basal ganglia intracerebral hemorrhage.Methods 96 patients with cerebral hemorrhage of small basal ganglia treated in this hospital from March 2014 to February 2017 were randomly divided into the conservative group and the operation group,with 48 cases in each group.The conservative group was treated by conservative method,and the operation group was treated with early micropore surgery.The edema volume of hematoma in two groups before treatment,3 days after treatment and 14 days after treatment was compared.The nerve function between the two groups was compared by the National Institutes of Health Stroke Scale(NIHSS)scale,daily life ability scale Barthel index(BI).Results 3 days after treatment and 14 days after treatment,the hematoma and edema volume of the operation group and the conservative group was[(8.45±1.55),(2.03±0.47),(13.51±2.78),(5.97±1.13)mL]respectively,significantly lower than that of before treatment[(26.43±6.17),(26.38±5.86)mL],and the hematoma and edema volume of the operation group decreased more significantly compared with that of the conservative group,the difference was statistically significant(P<0.05).After treatment of 3 days and after treatment of 14 days,NIHSS of the operation group and the conservative group was[(15.45±3.68)points,(7.93±2.37)points,(23.21±4.68)points,(9.49±2.24)points]respectively,significantly decreased than that of before treatment[(31.25±5.19)points,(31.29±5.06)points],BI scores of the operation group and the conservative group was[(48.57±6.87)points,(61.47±9.42)points,(39.46±5.77)points,(50.31±6.78)points],significantly increased than that of before treatment[(27.63±4.52)points,(27.58±4.87)points],and that of the surgery group was more significantly than that of the control group,the difference was statistically significant(P<0.05).Conclusion Compared with conservative tr

关 键 词：微孔手术 保守治疗 中小量 基底节脑出血后脑水肿 神经功能 

分 类 号：R544.1[医药卫生—心血管疾病]