比较微创穿刺引流术与小骨窗开颅血肿清除术治疗高血压脑出血的临床疗效

摘要

目的 探讨微创穿刺引流术与小骨窗开颅血肿清除术治疗高血压脑出血的临床效果.方法 方便选择2016年2月-2018年2月该院收治的60例高血压脑出血患者为研究对象,采用随机数表法分为两组,每组30例.对照组采用小骨窗开颅血肿清除术治疗,观察组采用微创穿刺引流术治疗.评价两组手术情况、临床疗效及术后并发症发生情况.结果 对照组术中出血量[(189.12±37.98)mL]、手术时间[(2.60±0.83)h]及术后住院时间[(27.12±3.85)d]]均高于观察组[(43.75±7.69)mL、(1.55±0.47)h、(22.04±4.78)d],差异有统计学意义(t=20.547、6.029、4.533,P＜0.05);对照组两组死亡率、重残率及治疗有效率分别为6.67％、26.67％、66.67％,观察组为6.67％、23.33％、70.00％,两组对比差异无统计学意义(χ2=0.000、0.089、0.077,P＞0.05);对照组术后并发症发生率为28.57％高于研究组的6.67％,差异有统计学意义(χ2=4.320,P＜0.05).结论 微创穿刺引流术与小骨窗开颅血肿清除术治疗高血压脑出血的临床疗效相当, 但微创穿刺引流术手术创伤更小、并发症发生率低、恢复快,具有更高的应用价值.%Objective To investigate the clinical effect of minimally invasive puncture drainage and small bone window craniotomy for the treatment of hypertensive cerebral hemorrhage. Methods 60 patients with hypertensive cerebral hemorrhage admitted to our hospital from February 2016 to February 2018 were convenient enrolled in the study. They were randomly divided into two groups, 30 in each group. The control group was treated with small bone window craniotomy hematoma evacuation, and the observation group was treated with minimally invasive puncture drainage. The operation, clinical efficacy and postoperative complications of the two groups were evaluated. Results Intraoperative blood loss [(189.12±37.98)mL], operation time [(2.60±0.83)h] and postoperative hospital stay[(27.12±3.85)d]] were higher than those in the observation group [(43.75±7.69)mL, (1.55±0.47)h, (22.04±4.78)d], the difference was statistically significant (t=20.547, 6.029, 4.533, P＜0.05); the mortality, severe disability and treatment efficiencies in the control group were 6.67％, 26.67％, and 66.67％, respectively. The observation group was 6.67％, 23.33％, and 70.00％. There was no significant difference between the two groups (χ2=0.000, 0.089, 0.077, P＞0.05). The complication rate was 28.57％ higher than that of the study group (6.67％), and the difference was statistically significant (χ2=4.320, P＜0.05). Conclusion The minimally invasive puncture drainage and small bone window craniotomy hematoma removal are effective in the treatment of hypertensive cerebral hemorrhage, but minimally invasive puncture drainage has less trauma, lower complication rate and faster recovery, and has higher application value.