早期微创穿刺引流术治疗高血压性基底节区脑出血的临床效果  

Clinical effect of early minimally invasive puncture and drainage for hypertensive basal ganglia intracerebral hemorrhage

作　　者：汪春晖[1] 金秀兰 陈淑媛 WANG Chunhui;JIN Xiulan;CHEN Shuyuan(Department of Neurosurgery,Huichang County People′s Hospital of Jiangxi Province,Ganzhou,Jiangxi,342600;Department of Surgery,Huichang County People′s Hospital of Jiangxi Province,Ganzhou,Jiangxi,342600)

机构地区：[1]江西省会昌县人民医院神经外科,江西赣州342600 [2]江西省会昌县人民医院外科,江西赣州342600

出　　处：《实用临床医药杂志》2020年第17期79-82,共4页Journal of Clinical Medicine in Practice

摘　　要：目的观察早期微创穿刺引流术治疗高血压性基底节区脑出血的临床效果。方法回顾性分析72例高血压性基底节区脑出血患者的临床资料,根据治疗方案不同分为对照组(n=30)和观察组(n=42)。对照组采用保守药物治疗,必要时行开颅血肿清除术,观察组行早期微创穿刺引流术治疗。比较2组治疗疗效、水肿带变化、美国国立卫生研究院卒中量表(NIHSS)神经功能评分及预后情况。结果观察组血肿清除率显著高于对照组,再出血率、并发症发生率显著低于对照组(P<0.05);2组病死率比较,差异无统计学意义(P>0.05);对照组治疗后第1、4、7、10天水肿带均增高,与入院时比较差异有统计学意义(P<0.05);观察组治疗后第1、4、7、10天水肿带较术前显著减轻(P<0.05),且与对照组比较,差异均有统计学意义(P<0.05)。观察组治疗后第1、3个月NIHSS评分低于对照组,预后良好率高于对照组,差异均有统计学意义(P<0.05)。结论早期微创穿刺引流术能有效改善高血压性基底节区脑出血患者的神经功能,减少并发症和改善预后,临床疗效显著。Objective To observe the clinical effect of early minimally invasive puncture and drainage in the treatment of hypertensive basal ganglia cerebral hemorrhage. Methods Clinical data of 72 patients with hypertensive basal ganglia hemorrhage was retrospectively analyzed,and they were divided into control group( n = 30) and observation group( n = 42) according to different treatment plans. The control group used conservative drug therapy,and implemented removal of hematoma necessarily. The observation group was given early minimally invasive puncture and drainage treatment.The efficacy,edema zone changes,National Institutes of Health Stroke Scale( NIHSS) score of neurological function and prognosis of the two groups were compared. Results The hematoma clearance rate of the observation group was significantly higher,and the rate of re-bleeding and incidence of complications were significantly lower than those of the control group( P < 0. 05). There was no significant difference in mortality rate between the two groups( P > 0. 05). The edema zone of the control group at 1,4,7 and 10 d after treatment was increased,which showed significant difference compared with that at admission( P < 0. 05),while was significantly reduced in the observation group at 1,4,7 and10 d after treatment compared with treatment before( P < 0. 05),and there was also a significant difference between the observation group and the control group after treatment in the same time points( P < 0. 05). NIHSS scores in the observation group at 1 month and 3 months after treatment were significantly lower than those in the control group,and the favorable prognosis rate in the observation group was significantly higher than that in the control group( P < 0. 05). Conclusion Early minimally pinvasive uncture and drainage has significant efficacy,and can effectively improve the neurological function of patients with hypertensive basal ganglia cerebral hemorrhage,reduce complications and improve prognosis.

关 键 词：高血压性脑出血 基底节区出血 穿刺引流 药物治疗 血肿清除 预后 神经功能 

分 类 号：R651.1[医药卫生—外科学]