软通道手术与小骨窗开颅血肿清除术治疗基底核出血的临床效果比较

摘要

Objective To compare the clinical effect on basal ganglia hemorrhage between soft channel surgery and small - window craniotomy for evacuation of hematoma. Methods A total of 100 patients with basal ganglia hemorrhage were selected in the Second People′s Hospital of Zhanjiang from January 2012 to June 2015,and they were divided into A group(n =48)and B group(n = 52) according to therapeutic methods. Patients of A group were treated by soft channel surgery,while patients of B group were treated by small - window craniotomy for evacuation of hematoma. MoCA score,Fugl-Meyer score and NIHSS score before surgery and after 1 month of surgery,clinical effect and incidence of complications were compared between the two groups. Results No statistically significant differences of MoCA score,Fugl-Meyer score or NIHSS score was found between the two groups before surgery,nor was NIHSS score between the two groups after 1 month of surgery(P ﹥ 0. 05),while MoCA score and Fugl-Meyer score of A group were statistically significantly higher than those of B group after 1 month of surgery (P < 0. 05). The clinical effect of A group was statistically significantly better than that of B group(P < 0. 05). No statistically significant differences of rehaemorrhagia,pulmonary infection,multiple organ failure or secondary epilepsy was found between the two groups(P ﹥ 0. 05). Conclusion Soft channel surgery has better clinical effect in treating basal ganglia hemorrhage than small - window craniotomy for evacuation of hematoma,can more effectively improve the cognitive function,limb movement function and prognosis,with less complications.%目的：比较软通道手术与小骨窗开颅血肿清除术治疗基底核出血的临床效果。方法选取2012年1月—2015年6月湛江市第二人民医院收治的基底核出血患者100例，根据治疗方法分为微创组48例与开颅组52例。微创组患者予以软通道手术，开颅组患者予以小骨窗开颅血肿清除术。比较两组患者术前及术后1个月蒙特利尔认知评估（MoCA）量表评分、Fugl-Meyer运动功能量表（Fugl-Meyer）评分、美国国立卫生研究院卒中量表（NIHSS）评分、临床效果及并发症发生情况。结果术前两组患者 MoCA 量表评分比较，差异无统计学意义（P ﹥0.05）；术后1个月微创组患者 MoCA 量表评分高于开颅组（ P ＜0.05）。术前两组患者Fugl-Meyer评分比较，差异无统计学意义（ P ﹥0.05）；术后1个月微创组患者Fugl-Meyer评分高于开颅组（P ＜0.05）。术前、术后1个月两组患者 NIHSS 评分比较，差异无统计学意义（P ﹥0.05）。微创组患者临床效果优于开颅组（P ＜0.05）。两组患者再出血、肺部感染、多脏器功能衰竭、继发性癫痫发生率比较，差异无统计学意义（P ﹥0.05）。结论软通道手术治疗基底核出血的临床效果优于小骨窗开颅血肿清除术，可更有效地改善患者认知功能、肢体运动功能及预后，且并发症较少。