软通道穿刺引流术治疗中等量高血压脑出血的临床研究

Clinical effect of soft-channel puncture drainage in treatment of moderate hypertensive intracerebral hemorrhage

摘要:

目的 探讨软通道穿刺引流术与开颅血肿清除术及内科保守治疗在中等量高血压脑出血患者中的疗效差别。方法 回顾性分析我科2016年3月至2019年3月收治的114例中等量高血压脑出血病例，根据治疗方法不同分为：穿刺组48例，开颅组34例，保守组32例，比较三组病例的并发症发生率、远期疗效及平均住院日。结果 穿刺组并发症发生率较开颅组及保守组低，差异有统计学意义（P<0.05）；发病后3个月ADL分级比较，穿刺组明显优于开颅组及保守组；穿刺组的平均住院日（20.3±2.2）d明显短于开颅组（26.4±3.5）d及保守组（27.6±2.8）d（P<0.05）。结论 软通道穿刺引流术治疗中等量高血压脑出血预后优于开颅手术及保守治疗，适合在基层医院广泛开展。

Abstract:

Objective To investigate the clinical effect of soft-channel puncture drainage versus hematoma clearance via craniotomy and conservative medical treatment in the treatment of patients with moderate hypertensive intracerebral hemorrhage.Methods A retrospective analysis was performed for the clinical data of 114 patients with moderate hypertensive intracerebral hemorrhage who were admitted to our department from March 2016 to March 2019. According to the treatment method, they were divided into puncture group with 48 patients, craniotomy group with 34 patients, and conservative group with 32 patients. The three groups were compared in terms of the incidence rate of complications, long-term efficacy, average length of hospital stay.Results The puncture group had a significantly lower incidence rate of complications than the craniotomy group and the conservative group (P<0.05). The puncture group had a significantly better ADL classification at 3 months after onset than the craniotomy group and the conservative group. The puncture group had a significantly shorter mean length of hospital stay than the craniotomy group and the conservative group (20.3±2.2 d vs 26.4±3.5 d and 27.6±2.8 d, P<0.05).Conclusions Soft-channel puncture drainage has a better clinical effect than craniotomy and conservative treatment in the treatment of moderate hypertensive intracerebral hemorrhage, with good socioeconomic benefits, and therefore, it holds promise for clinical application in primary hospitals.