摘要
目的比较微创锥颅立体定向软通道置管血肿引流术与传统开颅血肿清除术治疗高血压基底核区出血的临床效果。方法选取2014年6月-2018年6月安徽医科大学附属六安市人民医院神经外科收治的高血压基底核区出血患者110例,采用随机数字表法分为对照组和观察组,每组55例。对照组患者行传统开颅血肿清除术,观察组患者行微创锥颅立体定向软通道置管血肿引流术。比较两组患者临床效果和治疗前及治疗后2周格拉斯哥昏迷量表(GCS)评分、斯堪的纳维亚卒中量表(SSS)评分、血清炎性因子[包括C反应蛋白(CRP)、降钙素原(PCT)]水平、Barthel指数、改良Rankin量表(mRS)评分,并观察两组患者术后并发症发生情况。结果观察组患者临床效果优于对照组(P<0.05)。两组患者治疗前GCS评分、SSS评分、血清CRP、PCT水平及Barthel指数、mRS评分比较,差异无统计学意义(P>0.05);观察组患者治疗后2周GCS评分、SSS评分、Barthel指数高于对照组,血清CRP、PCT水平及mRS评分低于对照组(P<0.05)。观察组患者术后并发症发生率低于对照组(P<0.05)。结论微创锥颅立体定向软通道置管血肿引流术治疗高血压基底核区出血患者的临床效果优于传统开颅血肿清除术,可更有效地减轻患者炎性反应,改善患者神经功能,提高患者日常生活能力,且安全性较高。
Objective To compare the clinical effect on hypertensive basal ganglia hemorrhage between minimally invasive stereospecific skull-drilling soft-channel hematoma drainage and traditional craniotomy for hematoma evacuation.Methods A total of 110 patients with hypertensive basal ganglia hemorrhage were selected in Liuan People’s Hospital Affiliated to Anhui Medical University from June 2014 to June 2018,and they were divided into control group and observation group according to random number table method,with 55 cases in each group.Patients in control group received traditional craniotomy for hematoma evacuation,while patients in observation group received minimally invasive stereospecific skull-drilling softchannel hematoma drainage.Clinical effect,pre-and post-treatment GCS score,SSS score,serum inflammatory cytokines(including CRP and PCT)levels and Barthel index,mRS score before treatment and 2 weeks after treatment were compared between the two groups,and incidence of postoperative complications was observed.Results Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).There was no statistically significant difference in GCS score,SSS score,serum level of CRP or PCT,Barthel index or mRS score between the two groups before treatment(P>0.05);GCS score,SSS score and Barthel index in observation group were statistically significantly higher than those in control group,while serum levels of CRP and PCT,mRS score in observation group were statistically significantly lower than those in control group 2 weeks after treatment(P<0.05).Incidence of postoperative complications in observation group was statistically significantly lower than that in control group(P<0.05).Conclusion Minimally invasive stereospecific skulldrilling soft-channel hematoma drainage has better clinical effect than traditional craniotomy for hematoma evacuation in treating hypertensive basal ganglia hemorrhage,which can more effectively reduce the inflammatory reaction,improve the neurological function and activity of daily living of patients,and with higher safety.
作者
韩笑
HAN Xiao(Department of Neurosurgery,Liuan People's Hospital Affiliated to Anhui Medical University,Liuan 237000,China)
出处
《实用心脑肺血管病杂志》
2019年第11期69-72,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
颅内出血
高血压性
微创软通道
开颅血肿清除术
神经功能
日常生活能力
疗效比较研究
Intracranial hemorrhage,hypertensive
Minimally invasive soft channel
Craniotomy for hematoma evacuation
Neurological function
Activity of daily living
Comparative effectiveness research
