微创血肿清除术联合亚低温治疗高血压脑出血临床观察

摘要

目的 研究微创血肿清除术联合亚低温治疗高血压脑出血的临床疗效.方法 将128例高血压脑出血患者分为3组:常规治疗组行内科保守治疗;微创治疗组在常规治疗的同时行微创血肿清除术;联合治疗组行常规治疗+微创血肿清除术+亚低温治疗.比较3组治疗前后神经功能缺损评分(NIHSS)和治疗后随访90 d时的日常生活能力Barthel指数.结果 治疗30、90 d后NIHSS评分联合治疗组[(6.4±4.2)分、(1.9±1.2)分]低于微创治疗组[(8.1±2.7)分、(3.2±2.4)分],微创治疗组低于常规治疗组[(9.9±3.2)分、(5.4±1.7)分](均P＜0.05);治疗90 d后Barthel指数微创治疗组为(56.4±36.2)分,大于常规治疗组的(40.6±21.2)分,联合治疗组为(78.7±51.9)分,大于微创治疗组,差异均有统计学意义(P＜0.05).结论 微创血肿清除术和亚低温联合治疗高血压脑出血可明显降低病死率和致残率,有利于神经功能恢复.%Objective To explore the clinical effect of minimally invasive surgery combined with mild hypothermia in treatment of hypertensive cerebral hemorrhage. Methods One hundred and twenty-eight cases with hypertensive cerebral hemorrhage were divided into three groups randomly: standard therapy group with medical conservative treatment; minimally invasive surgery group with cleaning intracranial hemorrhage at the time of medical therapy; combined therapy group with medical therapy and cleaning intracranial hemorrhage at the time of mild hypothermia therapy. Three groups with the National institute of Health Stroke scale (NIHSS) score was compared. The clinical therapeutic effects and Barthel index which was accessed in both groups before treatment and ninety days later. Results The total clinical NIHSS was lower than minimally invasive surgery group,the NIHSS in minimally invasive surgery group was lower than the medical therapy group ( P ＜ 0.05 ); after 90 days, the barthel index ( 56.36 ±36.16) in the minimally invasive surgery group was higher than the barthel index (40. 56 ±21.22) in the medical therapy group. The barthel index(78.66 ±51.92) in the combined therapy group was higher than that in the minimally invasive surgery group (P ＜ 0.05 ). Conclusion Combined therapy of minimally invasive surgery and mild hypothermia can significant reduce morbidity and disability rates and improve renew nerval function.