微创穿刺术在自发性脑大出血治疗中的应用
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摘要
目的 :探讨微创穿刺术在自发性脑大出血治疗中的应用效果。方法 :选取自发性脑大出血患者78例,按照随机数字表法,分为对照组和观察组各39例。对照组接受保守治疗,观察组接受微创穿刺术治疗。比较两组病死率、治疗有效率、存活者Barthel评分和并发症发生率。结果 :观察组病死率低于对照组(P<0.05)。两组中出血量≥80ml或GCS评分<9分患者死亡率为100.00%;两组治疗总有效率、并发症发生率和Barthel指数评分差异无统计学意义(P>0.05)。结论 :自发性脑大出血患者接受微创穿刺术治疗的效果显著,可有效降低患者的病死率,但当患者出血量≥80 ml或GCS<9分时,则手术治疗无法改善其预后。
Objective: To investigate the application of minimally invasive puncture in the treatment of spontaneous massive intracerebral hemorrhage. Methods: The clinical data from 78 cases of patients with spontaneous intracerebral hemorrhage were retrospectively analyzed. The patients were divided into a conservative group(treated with conservative therapy) and an observation group(treated with minimally invasive puncture) with 39 cases each based on random number tables. Mortality, effective rate, Barthel score of the survival and the incidence of complications were compared between the two groups. Results: The mortality was lower in the observation group than the control group(P<0.05) and accounted for 100% in the patients with bleeding volume≥ 80 ml or Glasgow coma score(GCS) <9. There were no significant differences between the two groups in total effective rate, the incidence of complications and Barthel index(P>0.05). Conclusion: The application of minimally invasive puncture in the patients with spontaneous intracerebral hemorrhage has significant efficacy and can effectively reduce the mortality. However, the prognosis will not be improved for the patients with the bleeding volume ≥ 80 ml or GCS <9.
Objective: To investigate the application of minimally invasive puncture in the treatment of spontaneous massive intracerebral hemorrhage. Methods: The clinical data from 78 cases of patients with spontaneous intracerebral hemorrhage were retrospectively analyzed. The patients were divided into a conservative group(treated with conservative therapy) and an observation group(treated with minimally invasive puncture) with 39 cases each based on random number tables. Mortality, effective rate, Barthel score of the survival and the incidence of complications were compared between the two groups. Results: The mortality was lower in the observation group than the control group(P<0.05) and accounted for 100% in the patients with bleeding volume≥ 80 ml or Glasgow coma score(GCS) <9. There were no significant differences between the two groups in total effective rate, the incidence of complications and Barthel index(P>0.05). Conclusion: The application of minimally invasive puncture in the patients with spontaneous intracerebral hemorrhage has significant efficacy and can effectively reduce the mortality. However, the prognosis will not be improved for the patients with the bleeding volume ≥ 80 ml or GCS <9.
引文
[1]宁杰.微创穿刺引流联合开颅血肿清除术治疗高血压脑出血合并脑疝效果分析[J].河南医学研究, 2018, 27(12):2250-2251.
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[2]孙昭胜,赵旺淼,葛春燕,等.开颅血肿清除术和钻孔引流术治疗中等量基底核区高血压脑出血的临床疗效比较研究[J].中国全科医学, 2018, 21(6):702-706.
[3]于明,贾海玉,李国春.急性脑出血患者血液流变学指标变化的相关研究[J].临床神经病学, 2017, 30(1):1-4.
[4]张泰铭,宋少谦,于剑,等.脑出血硬通道与软通道微创穿刺术的Meta分析[J].中国微侵袭神经外科, 2017, 22(1):1-6.
[5]秦懿囡,杨红玲,张杰,等.针刺治疗脑出血常见后遗症临床研究进展[J].辽宁中医药大学学报, 2017, 19(2):130-132.
[6]任军伟,吴惺,胡锦,等.自发性脑出血患者的颅内压、脑灌注压与血压调控研究进展[J].国际神经病学神经外科学, 2016, 43(3):251-254.
[7]官念,吴碧华,刘黎明,等.脑出血病因及相关机制的研究进展[J].中华老年心脑血管病, 2016, 18(6):670-672.
[8]叶富跃,杨堃,郑传宜,等.颅内微创血肿清除术与传统开颅清除血肿手术在高血压脑出血中的应用效果分析[J].河北医学, 2016, 22(1):17-20.