微创血肿清除术与传统开颅手术在脑出血治疗中的疗效及安全性比较  

Comparison of efficacy and safety of minimally invasive hematoma evacuation and traditional craniotomy in the treatment of cerebral hemorrhage

作　　者：季明[1] JI Ming(Department of Neurosurgery,Chifeng Municipal Hospital of Inner Mongolia,Chifeng 024000,China)

机构地区：[1]内蒙古赤峰市医院神经外科二病区,024000

出　　处：《中国实用医药》2024年第14期69-72,共4页China Practical Medicine

摘　　要：目的对比微创血肿清除术和传统开颅手术治疗脑出血的疗效及安全性差异。方法选取67例经传统开颅手术治疗的脑出血患者作为对照组,另外将经微创血肿清除术治疗的66例脑出血患者作为观察组。对比两组患者的临床疗效、手术指标(手术时间、术中出血量、术后引流时间、术后清醒时间、住院时间)、康复指标[美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分]、并发症发生率。结果观察组的临床疗效明显优于对照组,差异有统计学意义(Z=2.7311,P<0.05)。观察组的手术时间、术后引流时间、术后清醒时间、住院时间分别为(5.54±1.05)h、(2.19±0.42)d、(5.76±1.09)d、(21.63±4.11)d,明显比对照组的(6.94±1.32)h、(3.58±0.68)d、(6.94±1.32)d、(23.95±4.55)d短,术中出血量(23.85±4.53)ml明显比对照组的(57.85±10.99)ml少,差异有统计学意义(P<0.05)。治疗后3个月,两组的NIHSS评分、GCS评分均低于治疗后1周,且观察组的NIHSS评分(6.62±1.29)分、GCS评分(3.18±0.62)分比对照组的(7.24±1.40)、(3.92±0.76)分低,差异有统计学意义(P<0.05)。观察组的并发症发生率(7.58%)明显比对照组(23.88%)低,差异有统计学意义(P<0.05)。结论相比传统开颅手术,对脑出血患者通过微创血肿清除术治疗能在确保安全的基础上提升疗效,优化手术指标,提升康复质量,值得推荐。Objective To compare the efficacy and safety of minimally invasive hematoma evacuation and traditional craniotomy in the treatment of cerebral hemorrhage.Methods 67 patients with cerebral hemorrhage treated by traditional craniotomy were selected as control group,and 66 patients with cerebral hemorrhage treated by minimally invasive hematoma evacuation as observation group.Patients in both groups were compared in terms of clinical efficacy,surgical indicators(operation time,intraoperative blood loss,postoperative drainage time,postoperative awake time,hospitalization time),rehabilitation indicators[National Institutes of Health Stroke Scale(NIHSS)score,Glasgow Coma Scale(GCS)score]and incidence of complications.Results The clinical efficacy of the observation group was significantly better than that of the control group,and the difference was statistically significant(Z=2.7311,P<0.05).The operation time,postoperative drainage time,postoperative awake time and hospitalization time of the observation group were(5.54±1.05)h,(2.19±0.42)d,(5.76±1.09)d and(21.63±4.11)d,which were significantly shorter than(6.94±1.32)h,(3.58±0.68)d,(6.94±1.32)d and(23.95±4.55)d of the control group;the intraoperative blood loss of the observation group was(23.85±4.53)ml,which was significantly less than(57.85±10.99)ml of the control group;the difference was statistically significant(P<0.05).At 3 months after treatment,the NIHSS scores and GCS scores in both groups were lower than those of 1 week after treatment;the observation group had NIHSS score of(6.62±1.29)points and GCS score of(3.18±0.62)points,which were lower than(7.24±1.40)and(3.92±0.76)points in the control group;the difference was statistically significant(P<0.05).The incidence of complications in the observation group(7.58%)was significantly lower than that in the control group(23.88%),and the difference was statistically significant(P<0.05).Conclusion Compared with traditional craniotomy,minimally invasive hematoma evacuation for patients with cerebral hemorr

关 键 词：微创血肿清除术 传统开颅手术 脑出血 康复 神经功能 意识 

分 类 号：R651.12[医药卫生—外科学]