微创软通道血肿穿刺引流术治疗中少量基底核区高血压脑出血的效果观察  

Effect of minimally invasive soft channel hematoma puncture drainage in the treatment of a small amount of hypertensive cerebral hemorrhage in basal ganglia region

作　　者：王宗宝[1] 李斌 王永胜[1] Wang Zongbao;Li Bin;Wang Yongsheng(Department of Neurosurgery,Binzhou Central HospItal,Binzhou 251700,China)

机构地区：[1]滨州市中心医院神经外科,山东滨州251700

出　　处：《中国临床实用医学》2020年第1期37-41,共5页China Clinical Practical Medicine

摘　　要：目的探讨微创软通道血肿穿刺引流术治疗中少量基底核区高血压脑出血与保守治疗基底核区高血压脑出血的效果。方法选取2013年1月至2017年6月滨州市中心医院神经外科收治的164例中少量基底核区高血压脑出血患者,男83例,女81例,年龄(56±8)岁,年龄范围为36~77岁,采用随机数表法将其随机分为传统治疗组与微创治疗组,每组82例。于患者治疗前、治疗后14 d、1个月、3个月及6个月进行神经功能缺损评分(NDS)和日常生活能力评定(ADL);并对微创治疗组和传统治疗组两组患者在14 d、1个月、3个月及6个月时的病死率、有效率及基本痊愈率进行比较。结果治疗前两组患者NDS比较,差异无统计学意义(P>0.05);微创治疗组在治疗后14 d[(21.17±4.97)分]、1个月[(18.38±5.26)分]、3个月[(12.73±3.98)分]、6个月[(8.67±3.46)分]NDS均优于传统治疗组[(28.14±5.82)分、(26.67±5.03)分、(18.15±4.17)分、(13.19±3.54)分],差异有统计学意义(P<0.05)。治疗前两组患者ADL比较,差异无统计学意义(P>0.05);微创治疗组患者在治疗后14 d[(24.34±4.64)分]、1个月[(41.54±4.51)分]、3个月[(80.84±4.36)分]、6个月[(92.29±3.76)分]ADL均优于传统治疗组[(16.26±4.32)分、(20.67±4.63)分、(65.15±4.16)分、(86.86±3.61)分],差异有统计学意义(P<0.05)。微创治疗组患者治疗后14 d基本痊愈率[12.2%(10/82)]、有效率[75.6%(62/82)]、病死率[1.2%(1/82)]均优于传统治疗组[3.7%(3/82)、46.3%(38/82)、4.9%(4/82)]患者;治疗后一个月基本痊愈率[19.5%(16/82)]、有效率[84.1%(69/82)]、病死率[2.4%(2/82)]均优于传统治疗组[9.8%(8/82)、74.4%(61/82)、6.1%(5/82)]患者;治疗后三个月基本痊愈率[26.8%(22/82)]、有效率[92.7%(76/82)]、病死率[2.4%(2/82)]均优于传统治疗组[15.9%(13/82)、82.9%(68/82)、6.1%(5/82)]患者;治疗后六个月基本痊愈率[29.3%(2/82)]、有效率[95.1%(78/82)]、病死率[2.4%(2/82)]均优于传统治疗组[18.3%(5/82)、91.Objective To investigate the effects of minimally invasive soft channel hematoma puncture drainage and conservative treatment of a small or moderate amount of hypertensive cerebral hemorrhage in basal ganglia.Methods A retrospective study was performed on 164 cases of patients with small amount of basal ganglia hemorrhage who were admitted from January 2013 to June 2017.83 males and 81 females were aged(56±8)years old,langing from 36 to 77 years old.Patients were randomly divided into the traditional treatment group and the minimally invasive treatment group with 82 patients in each group.Neurologic deficit score(NDS)and daily living ability(ADL)were performed before,14 days,1 month,3 months and 6 months after treatment.Patients in the minimally invasive treatment group and the traditional treatment group were compared in terms of mortality,effective rate and basic recovery rate at 14 days,1 month,3 months and 6 months.Results There was no significant difference in NDS between the two groups before treatment(P>0.05).NDS of the minimally invasive treatment group was better than that of the conventional treatment group at 14 days[(21.17±4.97)],1 month[(18.38±5.26)],3 months[(12.73±3.98)]and 6 months[(8.67±3.46)],with statistically significant differences(P<0.05).There was no significant difference in ADL between the two groups before treatment(P>0.05).The ADL of the minimally invasive treatment group was better than that of the traditional treatment group at 14 days[(24.34±4.64)],1 month[(41.54±4.51)],3 months[(80.84±4.36)]and 6 months[(92.29±3.76)],with statistically significant differences(P<0.05).The recovery rate[12.2%(10/82)],the effective rate[75.6%(62/82)],and the death rate[1.2%(1/82)]of the minimally invasive treatment group were all better than those of the traditional treatment group[3.7%(3/82),46.3%(38/82)and 4.9%(4/82)].One months after the treatment,the basic recovery rate[19.5%(16/82)],effective rate[84.1%(69/82)]and mortality[2.4%(2/82)]were all better than those in the traditional treatmen

关 键 词：脑出血 微创穿刺 基底核区 高血压 神经功能缺失评分 日常生活能力评定 

分 类 号：R651[医药卫生—外科学] R544[医药卫生—临床医学]