小骨窗血腫清除術(shù)與微創(chuàng)穿刺血腫引流術(shù)治療高血壓腦出血的效果比較

　　摘   要：目的   比較分析小骨窗血腫清除術(shù)與微創(chuàng)穿刺血腫引流術(shù)治療高血壓腦出血患者的臨床效果。方法  選擇2014年1月～2016年12月在我院進(jìn)行診治的196例高血壓腦出血患者，隨機(jī)分為研究組與對(duì)照組，各98例。對(duì)照組給予小骨窗血腫清除術(shù)治療，研究組給予微創(chuàng)穿刺血腫引流術(shù)治療。觀察并記錄兩組再出血、血腫殘留以及肺部感染、顱內(nèi)感染和應(yīng)激性潰瘍等術(shù)后并發(fā)癥的發(fā)生情況。對(duì)比兩組患者治療前后的神經(jīng)功能缺損評(píng)分和日常生活能力評(píng)分。結(jié)果  兩組血腫殘留以及肺部感染、顱內(nèi)感染和應(yīng)激性潰瘍等術(shù)后并發(fā)癥的發(fā)生率相比差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;研究組再出血的發(fā)生率為16.33%，明顯低于對(duì)照組的38.78%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;治療后兩組的神經(jīng)功能缺損評(píng)分均明顯降低，與治療前比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），日常生活能力評(píng)分明顯升高，與治療前比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;且研究組的神經(jīng)功能缺損評(píng)分低于對(duì)照組[（9.15±1.54）分vs（20.15±3.73）分]，日常生活能力評(píng)分高于對(duì)照組[（93.25±3.37）分vs（82.07±3.54）分]，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論  微創(chuàng)穿刺血腫引流術(shù)治療高血壓腦出血患者的臨床效果顯著優(yōu)于小骨窗血腫清除術(shù)，不僅可以有效改善患者的神經(jīng)功能以及日常生活能力，還能降低再出血的發(fā)生率，不增加術(shù)后并發(fā)癥，安全有效，值得應(yīng)用推廣。
　　關(guān)鍵詞：小骨窗血腫清除術(shù);微創(chuàng)穿刺血腫引流術(shù);高血壓腦出血
　　中圖分類號(hào)：R651.1                                  文獻(xiàn)標(biāo)識(shí)碼：A                                DOI：10.3969/j.issn.1006-1959.2018.05.035
　　文章編號(hào)：1006-1959（2018）05-0105-03
　　Comparison of Small Window Hematoma Clearance and Minimally Invasive Hematoma Drainage in the Treatment of Hypertensive Intracerebral Hemorrhage
　　HAN Dong
　�。―epartment of Emergency，Armed Police Frontier General Hospital，Shenzhen 51802929，Guangdong，China）
　　Abstract：Objective  To compare and analyze the small bone window hematoma with minimally invasive puncture drainage of hematoma in patients with clinical effect in the treatment of hypertensive cerebral hemorrhage.Methods  From January 2014～December 2016 in our hospital for diagnosis and treatment of 196 cases of patients with hypertensive cerebral hemorrhage were randomly divided into study group and control group，98 cases in each group.The control group was given small bone window hematoma and the study group received minimally invasive hematoma drainage treatment.Observe and record the two groups of rebleeding，residual hematoma，pulmonary infection，intracranial infection and stress ulcer and other complications.Compared two groups of patients before and after the neurological deficit scores and ADL scores.Results  Two groups of residual hematoma and pulmonary infection，intracranial infection and stress ulcer incidence of postoperative complications had no significant difference（P>0.05）;the study group the incidence of rebleeding was 16.33%，significantly lower than the control group 38.78%，the difference was statistically significant（P<0.05）;after the treatment of neurological function score the defects of two group were significantly decreased，there was significant difference compared with before treatment（P<0.05），ADL score increased significantly， there was significant difference compared with before treatment（P<0.05）;The neurological deficit score of the study group was lower than that of the control group [（9.15±1.54）vs（20.15±3.73）]，and the ADL score was higher than that of the control group[（93.25±3.37）vs（82.07±3.54）]，and the difference was statistically significant（P<0.05）.Conclusion  The clinical effect of minimally invasive hematoma drainage in patients with hypertensive intracerebral hemorrhage is significantly better than that of small bone window hematoma clearance.It can not only effectively improve the neurological function and daily living ability of the patients，but also reduce the incidence of rebleeding.It is safe and effective without increasing postoperative complications and is worth popularizing.

相關(guān)熱詞搜索：血腫 腦出血 穿刺 治療高血壓 微創(chuàng)