硬通道多孔微创引流术治疗高血压基底节脑出血的可行性及安全性研究

摘要

目的：探究硬通道多孔微创手术治疗高血压基底节脑出血的可行性及安全性，旨在进一步提高脑出血治疗水平。方法：选取2013年5月-2015年5月本院收治的高血压基底节脑出血患者共79例，按照入院时间顺序分为对照组39例与观察组40例，对照组接受开颅血肿清除术治疗，观察组接受硬通道多孔微创引流术治疗。比较两组患者脑出血手术情况、血肿清除率、术后并发症及预后神经功能。结果：观察组手术持续时间与住院时间均明显短于对照组（P<0.05）。观察组血肿清除率为（81.26±4.25）%，明显高于对照组血肿清除率（68.31±3.58）%，比较差异有统计学意义（P<0.05）。观察组术后并发症发生率为20.0%，明显高于对照组并发症发生率5.1%，比较差异有统计学意义（P<0.05）。观察组术后1、3个月GOS评分及Barthel指数均明显高于对照组（P<0.05）。结论：硬通道多孔微创手术治疗高血压基底节脑出血具有较好的效果，能有效清除血肿，改善预后神经功能及日常生活活动能力优于开颅血肿清除术，但术后并发症发生率高于开颅血肿清除术，应结合患者具体情况综合考虑，选择合适的术式。%Objective:To explore the feasibility and safety of treatment minimally invasive drainage with hard channel on hypertensive basal ganglia intracerebral hemorrhage,and to further improve the treatment level of cerebral hemorrhage.Method:A total of 79 patients with hypertensive basal ganglia hemorrhage in our hospital from May 2013 to May 2015 were randomly divided into the control group(n=39) and the observation group (n=40) according to the time of admission.The control group received craniotomy hematoma removal operation,the observation group received the treatment of minimally invasive drainage with hard channel.The operation condition, hematoma removal rate,postoperative complications and prognosis of nerve function were compared between the two groups.Result:The duration of operation and hospitalization time of observation group were significantly shorter than those in control group(P<0.05).The hematoma clearance rate of observation group was (81.26±4.25)%,significantly higher than (68.31±3.58)% of the control group, the difference was statistically significant (P<0.05).The postoperative complication rate of observation group was 20.0%,which was significantly higher than 5.1% of the control group,the difference was statistically significant(P<0.05).The scores of GOS and Barthel in the observation group,significantly higher than those in the control group at 1 month,3 months after the surgery(P<0.05).Conclusion:The treatment of hypertensive basal ganglia hemorrhage with hard channel porous minimally invasive surgery has good effect,can effectively remove the hematoma,improve the prognosis of nerve function and daily living activity,better than that of craniotomy hematoma removal,but the postoperative complication rate is higher than that of craniotomy hematoma removal,and should be combined with the specific circumstances of the patient,choose the appropriate type of operation.