定向软通道微创救治高血压小脑出血  

Directed Soft Channel Minimally Invasive Treatment of Hypertensive Cerebellar Hemorrhage

作　　者：庄炳兴 张准仪 师少春 黄柳军 林小义 朱文锦 ZHUANG Bingxing;ZHANG Zhunyi;SHI Shaochun;HUANG Liujun;LIN Xiaoyi;ZHU Wenjin(Department of Surgery,Lufeng People's Hospital,Lufeng,Guangdong Province,516511 China)

机构地区：[1]广东省陆丰市人民医院外三科,广东陆丰516511

出　　处：《中外医疗》2021年第24期5-8,17,共5页China & Foreign Medical Treatment

基　　金：汕尾市科技计划项目(2015C026)。

摘　　要：目的探究在高血压小脑出血治疗中应用定向软通道微创干预的临床价值。方法方便选取该院在2015年7月—2017年7月间收治的108例高血压小脑出血患者为研究对象,采取随机分组形式将其随机分组两组,对照组(54例)予以传统后颅窝开颅减压血肿清除或保守治疗;观察组(54例)予以定向软通道“微创脑室外引流+小脑血肿吸引清除术”治疗;对比观察两种不同治疗方案下患者的以下指标:①临床指标;②炎症因子水平;③并发症发生率及血肿清除率;④预后情况;⑤生活质量。结果经治疗,各指标变化情况如下:①两组患者在不同治疗干预下仅术中出血量对比(36.77±7.26)mL vs(35.26±6.14)mL,差异无统计学意义(t=1.167,P>0.05),但观察组患者手术、血肿引流及住院时间分别为(88.26±20.10)min、(4.26±0.54)d、(7.89±2.03)d,均明显短于对照组的(108.36±20.15)min、(5.41±0.62)d、(9.12±1.87)d,差异有统计学意义(t=5.190、10.278、3.275,P<0.001);②治疗后观察组IL-6水平为(14.97±4.62)ng/L,对比对照组的(18.44±6.92)ng/L降低显著,差异有统计学意义(t=3.065,P<0.05);③观察组经治疗后发生并发症的概率为3.70%,明显低于对照组的16.67%,差异有统计学意义(χ^(2)=4.960,P<0.05),且观察组患者血肿清除率为88.89%,明显高于对照组的72.22%,差异有统计学意义(χ^(2)=4.788,P<0.05);④对比两组患者预后情况可见,观察组患者CGS评分明显高于对照组(12.81±2.40)分vs(11.25±2.64)分,差异有统计学意义(t=3.213,P<0.05),且NIHSS评分及ADL评分分别为(8.17±2.36)分、(31.09±3.02)分,明显低于对照组的(13.26±3.55)分、(39.45±2.77)分,差异有统计学意义(t=8.774、14.991,P<0.001);⑤比较两组患者WHOQOL-BREF评分可见,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论经该次研究证实,在高血压小脑出血治疗中应用定向软通道微创干预具有显著的临床价值,其不仅能够有效清除患者颅内Objective To explore the clinical value of applying directed soft channel minimally invasive intervention in the treatment of hypertensive cerebellar hemorrhage.Methods 108 patients with hypertensive cerebellar hemorrhage admitted in the hospital between July 2015 and July 2017 were conveniently selected as the research objects.They were randomly divided into 2 groups by randomization.The control group(54 cases)received traditional posterior cranial hemorrhage.Fossa craniotomy and decompression hematoma removal or conservative treatment;observation group(54 cases)were treated with directional soft channel"minimally invasive ventricular drainage+cerebellar hematoma aspiration removal";the following indicators of patients under two different treatment plans were compared and observed:1.Clinical indicators;2.level of inflammatory factors;3.complication rate and hematoma clearance rate;4.prognosis;5.quality of life.Results After treatment,the changes of each index were as follows:1.There was no statistically difference in intraoperative blood loss between the two groups under different treatment interventions(36.77±7.26)mL vs(35.26±6.14)mL(t=1.167,P>0.05),but the operation,hematoma drainage and hospitalization time of the observation group were(88.26±20.10)min,(4.26±0.54)d,and(7.89±2.03)d,which were significantly shorter than those of the control group(108.36±20.15)min,(5.41±0.62)d,(9.12±1.87)d,the difference was statistically significant(t=5.190,10.278,3.275,P<0.001);2.The IL-6 level of the observation group after treatment was(14.97±4.62)ng/L,compared with that of the control group(18.44±6.92)ng/L decreased significantly,the difference was statistically significant(t=3.065,P<0.05);3.The incidence of complications in the observation group after treatment was 3.70%,which was significantly lower than the 16.67%in the control group,the difference was statistically significant(χ^(2)=4.960,P<0.05),and the hematoma clearance rate of patients in the observation group was 88.89%,which was significantly higher tha

关 键 词：定向软通道 高血压小脑出血 微创脑室外引流 小脑血肿吸引清除术 

分 类 号：R5[医药卫生—内科学]