摘要
目的观察微创血肿穿刺引流术对高血压脑出血患者的治疗效果,及对患者神经功能和脑血管功能的影响。方法选取2015-03-05-2018-03-24登封市人民医院接受治疗的80例高血压脑出血患者为研究对象,并根据其治疗方式分为对照组(40例)和观察组(40例)。对照组采用传统血肿穿刺引流术,观察组给予微创血肿穿刺引流术,观察2组患者围手术期一般情况,比较2组患者手术前后颅内压值、神经功能和日常生活能力的差异。结果观察组患者手术时间为(60.12±6.03)min,短于对照组的(85.67±5.16)min,差异有统计学意义,t=20.361,P<0.001;2组患者血肿清除率差异无统计学意义,t=-0.111,P=0.456。术后6h,观察组患者颅内压为(3.12±0.98)kPa,低于对照组的(4.96±1.12)kPa,t=4.930,P<0.001;观察组国立卫生研究院卒中量表(NIHSS)评分为(14.13±2.31)分,低于对照组的(16.05±2.24)分,t=3.774,P<0.001。术后3个月,观察组日常生活能力总分为(97.02±10.35)分,高于对照组的(85.45±7.28)分,差异有统计学意义(t=5.783,P<0.001),其中观察组患者进食(t=5.159,P<0.001)、洗澡(t=4.105,P<0.001)、修饰(t=6.383,P<0.001)、穿衣(t=4.864,P<0.001)、大便控制(t=3.950,P<0.001)、小便控制(t=3.915,P<0.001)、如厕(t=2.577,P=0.012)、床椅转移(t=4.776,P<0.001)、平地行走(t=4.561,P<0.001)和上下楼梯(t=13.600,P<0.001)日常生活能力均优于对照组。观察组患者再出血0例,肢体障碍2例,死亡0例,对照组患者再出血2例,肢体障碍6例,死亡1例,预后不良事件发生率差异有统计学意义,P=0.048。结论微创血肿穿刺引流术可明显改善高血压脑出血患者颅内压和预后,有较好的临床应用效果。
Objective To observe the therapeutic effect of minimally invasive hematoma puncture and drainage in patients with hypertensive intracerebral hemorrhage,and the effect on the neurological function and cerebrovascular function of patients.Methods Eighty patients with hypertensive cerebral hemorrhage who were treated in Dengfeng People’s Hospital from March 5,2015 to March 24,2018 were selected as the research subjects,and were divided into control group(40 cases)and observation group(40 cases)according to their treatment methods.The control group was treated with traditional hematoma puncture and drainage,while the observation group was treated with minimally invasive hematoma puncture and drainage.The general conditions of patients in the two groups during perioperative period were observed,and the differences in intracranial pressure,neurological function and daily living ability before and after operation were compared between the two groups.Results The operation time in the observation group was(60.12±6.03)min,shorter than that in the control group(85.67±5.16)min,t=20.361,P<0.001.There was no statistical significance in hematoma clearance rate between 2 groups,t=-0.111,P=0.456.6 hafter operation,the intracranial pressure of observation group was(3.12±0.98)kPa,lower than that of control group(4.96±1.12)kPa,t=4.930,P<0.001.The national institutes of health stroke scale(NIHSS)score in the observation group was 14.13±2.31,lower than that in the control group(16.05±2.24),t=3.774,P<0.001.Three months after operation,the total score of daily living ability of the observation group was 97.02±10.35,which was higher than that of the control group(85.45±7.28),the difference was statistically significant,t=5.783,P<0.001.In terms of daily living ability,patients in the observation group were better at feeding(t=5.159,P<0.001),bathing(t=4.105,P<0.001),groping(t=6.383,P<0.001),dressing(t=4.864,P<0.001),stool control(t=3.950,P<0.001),urination control(t=3.915,P<0.001),toilet use(t=2.577,P=0.012),bedchair transfer(t=4.776,P<0.001),flat walking(t=4.561,P<0.001),up and down stairs(t=13.600,P<0.001)were better than the control group.In the observation group,there were 0 cases of rebleeding,2 cases of limb impairment,and 0 cases of death.In the control group,there were 2 cases of rebleeding,6 cases of limb impairment,and 1 case of death.The difference in the incidence of adverse events was statistically significant,P=0.048.Conclusion The application of minimally invasive hematoma puncture and drainage in patients with hypertensive intracerebral hemorrhage can significantly improve the intracranial pressure and prognosis of patients,and has a better clinical effect.
作者
李继锋
赵昊譞
LI Ji-feng;ZHAO Hao-xuan(Department of Neurology,Dengfeng People’s Hospital,Dengfeng 452470,China)
出处
《社区医学杂志》
CAS
2021年第14期861-864,共4页
Journal Of Community Medicine
关键词
微创血肿穿刺引流
高血压
脑出血
神经功能
日常生活能力
minimally invasive puncture and drainage of hematoma
hypertension
cerebral hemorrhage
neurological function
activities of daily living
