立体定向手术治疗高血压性脑出血的效果

摘要

目的 探讨CT立体定向微创软管道置管配合尿激酶治疗高血压性脑出血的效果.方法 回顾性分析北京中医药大学东方医院2012年10月～2017年5月收治的高血压性脑出血80例患者的临床资料,其中采用内科保守治疗的40例患者设为对照组,采用CT立体定向微创软通道置管配合尿激酶治疗的40例患者设为观察组,对两组的日常生活活动能力(ADL)、格拉斯哥预后评分(GOS)、格拉斯哥昏迷评分(GCS)、Barthel指数进行比较.结果 两组治疗30 d ADL分级改善比较,差异无统计学意义(P＞0.05).观察组治疗30、90 d GOS评分和治疗5 d GCS评分均明显高于对照组,治疗前与治疗30 d Barthel指数差值亦高于对照组,差异均有统计学意义(均P＜ 0.05).观察组并发症发生率明显低于对照组,差异有统计学意义(P＜0.05).结论 CT立体定向微创软通道置管配合尿激酶治疗高血压性脑出血的效果显著优于内科保守治疗,能够提高患者日常生活活动能力,减少并发症,具有积极的临床使用价值.%Objective To investigate the efficacy of CT stereotactic minimally invasive soft channel catheterization combined with urokinase in the treatment of hypertensive intracerebral hemorrhage.Methods The clinical data of 80 patients with hypertensive intracerebral hemorrhage admitted to Dongfang Hospital,Beijing University of Chinese Medicine from October 2012 to May 2017 was analyzed retrospectively.40 cases of patients taken conservative treatment of internal medicine were set as control group,40 cases of patients treated with CT stereotactic minimally invasive sofi channel catheterization combined with urokinase were set as observation group.The activities of daily living (ADL),Glasgow outcome score (GOS),Glasgow coma scale (GCS),Barthel index in the two groups were compared.Results There was no statistically significant difference of the improvement of ADL grading between the two groups (P ＞ 0.05).The scores of GOS after treatment for 30,90 days,and the scores of GCS after treatment for 5 days in the observation group were all higher than those of control group,and the difference of Barthel index before and after treatment for 30 days in the observation group was higher than that of control group,the differences were all statistically significant (all P ＜ 0.05).The incidence of complications in the observation group was lower than that of control group,the difference was statistically significant (P ＜ 0.05).Conclusion The effect of CT stereotactic microvascular catheterization combined with urokinase in the treatment of hypertensive intracerebral hemorrhage is significantly better than the conservative treatment,which can improve the activities of daily living,reduce complications,with a positive clinical use value.