摘要
目的探索立体定向微创手术治疗少量丘脑出血的临床效果。方法回顾性分析2019年10月至2022年5月收治的110例少量丘脑出血(出血量6~15 mL)的患者。治疗组患者(55例)采用立体定向微创手术治疗,对照组患者(55例)采用保守治疗方法。使用美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分(GCS)及扩充版格拉斯哥预后(GOS-E)评分对所有患者进行评估,比较2组患者入院时NIHSS评分、治疗后2周和治疗后4周时NIHSS评分的变化,治疗前后血肿量、GOS-E评分的变化,并发症发生率以及出院6个月后,患者的NIHSS及GOS-E评分,并进行统计学分析。结果治疗后2周、4周,治疗组NIHSS评分、GOS-E评分均优于对照组(P<0.05);治疗后3 d和7 d,2组血肿体积均小于入院时(P<0.05),且治疗组小于对照组(P<0.05);治疗组颅内感染发生率高于对照组(P<0.05),对照组脑积水、肺部感染及下肢血栓发生率高于治疗组(P<0.05);6个月后复诊,治疗组患者NIHSS评分显著低于对照组(P<0.05),治疗组GOS-E评分高于对照组(P<0.05)。结论与保守治疗效果相比,立体定向微创手术可显著改善少量丘脑出血患者的转归和预后。
Objective To explore the clinical effect of stereotactic minimally invasive surgery on the treatment of small amount of thalamic hemorrhage.Methods A retrospective analysis was performed on 110 patients with small amount of thalamic hemorrhage(hematoma volume 6-15mL)admitted to ouRhospital from OctobeR2019 to May 2022.Stereotactic minimally invasive surgery and conservative treatment were performed in the treatment group(55 cases)and the control group(55 cases),respectively.All patients were evaluated using the National Institutes of Health Stroke Scale(NIHSS),Glasgow Coma Score(GCS),and the expanded Glasgow Prognosis(GOS-E)score.Changes in the NIHSS score at admission,2 weeks afteRtreatment and 4 weeks afteRtreatment were compared between the two groups.Changes in hematoma volume and GOS-E score before and afteRtreatment were compared as well.The incidence of complications and the NIHSS and GOS-E scores at 6 months afteRdischarge were also compared.Results The 2-week and 4-week NIHSS score and GOS-E score in the treatment group were significantly betteRthan those of the control group(P<0.05).The 3-day and 7-day hematoma volume in the both groups were significantly smalleRthan those at admission(P<0.05),and which in the treatment group were significantly smalleRthan those of the control group(P<0.05).The incidence of intracranial infection in the treatment group was significantly higheRthan that of the control group(P<0.05).The incidence of hydrocephalus,pulmonary infection,and loweRextremity thrombosis in the treatment group was significantly loweRthan that of the control group(P<0.05).AfteR6 months of follow-up,the NIHSS score in the treatment group was significantly loweRthan that of the control group(P<0.05),and the GOS-E score in the treatment group was significantly higheRthan that of the control group(P<0.05).Conclusion The stereotactic minimally invasive surgery can significantly improve the outcome and prognosis of patients with small amounts of thalamic hemorrhage compared to the conservative treatment.
作者
吴晓赟
李京臣
WU Xiaoyun;LI Jingchen(Department of Geriatrics,the Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051,China)
出处
《河北医药》
CAS
2024年第11期1652-1655,1660,共5页
Hebei Medical Journal
基金
河北省医学科学研究课题计划(编号:20190636)。
关键词
丘脑出血
微创手术
立体定向
高血压脑出血
thalamic hemorrhage
minimally invasive surgery
stereotactic
hypertensive cerebral hemorrhage
