微创钻孔置管引流术与小骨窗开颅术治疗高血压脑出血患者的效果比较  

Comparison of effects of minimally invasive drilling and catheter drainage and small bone window craniotomy in treatment of patients with hypertensive cerebral hemorrhage

作　　者：郭锐 GUO Rui(Department of Neurosurgery of Qinyang People’s Hospital,Jiaozuo 454550 Henan,China)

机构地区：[1]沁阳市人民医院神经外科,河南焦作454550

出　　处：《中国民康医学》2024年第4期140-143,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较微创钻孔置管引流术与小骨窗开颅术治疗高血压脑出血(HICH)患者的效果。方法:回顾性分析2020年8月至2022年8月该院收治的86例HICH患者的临床资料,按照治疗方法不同将其分为研究组和对照组各43例。研究组采用微创钻孔置管引流术治疗,对照组采用小骨窗开颅术治疗,比较两组围术期指标水平,手术前后炎性指标[降钙素原(PCT)、C反应蛋白(CRP)]水平、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、日常生活能力[日常生活能力量表(ADL)]评分和术后2周并发症发生率。结果:研究组手术时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组拔管时血肿清除率比较,差异无统计学意义(P>0.05);术后3 d,两组PCT、CRP水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后3个月,研究组NIHSS评分低于对照组,ADL评分高于对照组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:微创钻孔置管引流术治疗HICH患者可提高ADL评分,缩短手术时间和住院时间,减少术中出血量,降低炎性指标水平和NIHSS评分,效果优于小骨窗开颅术治疗。Objective:To compare effects of minimally invasive drilling and catheter drainage and small bone window craniotomy in treatment of patients with hypertensive cerebral hemorrhage(HICH).Methods:The clinical data of 86 patients with HICH admitted to the hospital from August 2020 to August 2022 were retrospectively analyzed.According to different treatment methods,they were divided into study group and control group,43 cases in each group.The study group was treated with minimally invasive drilling and catheter drainage,while the control group was treated with small bone window craniotomy.The levels of perioperative indexes and inflammatory indexes[procalcitonin(PCT),C-reactive protein(CRP)],the neurological deficit degree[National Institutes of Health stroke scale(NIHSS)]score,the activities of daily living[activity of daily living scale(ADL)]score before and after the surgery,and the incidence of complications 2 weeks after the surgery were compared between the two groups.Results:The operation time and the hospitalization time of the study group was shorter than those of the control group,the intraoperative blood loss of the study group was less than that of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the hematoma clearance rate between the two groups during extubation(P>0.05).Three days after the surgery,the levels of PCT and CRP in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the NIHSS score of the study group was lower than that of the control group,the ADL score was higher than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Minimally invasive drilling and catheter drainage in the treatment of the HICH patien

关 键 词：小骨窗开颅手术 钻孔置管引流术 高血压脑出血 炎性指标 神经功能缺损 日常生活能力 并发症 

分 类 号：R743.34[医药卫生—神经病学与精神病学]