改良立体定向软通道微创穿刺引流术治疗高血压壳核脑出血的疗效观察
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摘要
目的:观察改良立体定向软通道微创穿刺引流术治疗高血压壳核脑出血的临床疗效。方法:选取2014年1月至2016年1月广西桂平市人民医院收治的高血压壳核脑出血患者130例,依据不同的治疗方法将其分为改良立体定向软通道微创穿刺引流术组(研究组,65例)和经颞硬通道微创穿刺引流术组(对照组,65例),对比两组患者的神经功能缺损程度、生活质量、临床疗效、血肿清除及并发症发生情况。结果:研究组患者的神经功能缺损评分显著低于对照组(P<0.05),日常生活能力(ADL)评分显著高于对照组(P<0.05)。研究组治疗总有效率为87.7%,显著高于对照组的70.8%(P<0.05);血肿清除情况显著优于对照组(P<0.05)。研究组总并发症发生率为4.6%,显著低于对照组的12.3%,差异具有统计学意义(P<0.05)。结论:改良立体定向软通道微创穿刺引流术治疗高血压壳核脑出血的疗效满意,损伤小,能较彻底地清除血肿,神经功能恢复好,操作简单,是治疗高血压壳核出血的安全、可靠的手术方法。
Objective:To observe the efficacy of minimally invasive puncture and drainage(MIPD)by improved stereotactic soft-channel on the treatment of hypertensive putaminal hemorrhage(HPH).Methods:130patients with HPH treated in our hospital from January 2014 to January 2016 were selected and divided into 2groups according to different treatment methods(n =65per group):a research group in which the patients received MIPD via improved stereotactic soft-channel,and a control group in which the patients received hard-channel MIPD.The National Institutes of Health Stroke Scale(NIHSS)score,life quality,clinical efficacy,hematoma clearance rate and the incidence of complications were compared.Results:The NIHSS score was lower,while the activities of daily living(ADL)score was higher in the research group than those in the control group(P <0.05).The total response rate was 87.7%,which was significantly higher than that in the control group(70.8%)(P <0.05).Patients in the research group had a higher rate of hematoma clearance than that in the control group(P <0.05).The incidence of complications was 4.6%in the research group and was 12.3%in the control group,and it was statistical different between the two groups(P <0.05).Conclusion:MIPD via improved stereotactic soft-channel was an effective and safe technology for the treatment of HPH,as manifested by a higher rate of hematoma clearance,better neurological function recovery,more simple operation as well as reduced complications in patients.
Objective:To observe the efficacy of minimally invasive puncture and drainage(MIPD)by improved stereotactic soft-channel on the treatment of hypertensive putaminal hemorrhage(HPH).Methods:130patients with HPH treated in our hospital from January 2014 to January 2016 were selected and divided into 2groups according to different treatment methods(n =65per group):a research group in which the patients received MIPD via improved stereotactic soft-channel,and a control group in which the patients received hard-channel MIPD.The National Institutes of Health Stroke Scale(NIHSS)score,life quality,clinical efficacy,hematoma clearance rate and the incidence of complications were compared.Results:The NIHSS score was lower,while the activities of daily living(ADL)score was higher in the research group than those in the control group(P <0.05).The total response rate was 87.7%,which was significantly higher than that in the control group(70.8%)(P <0.05).Patients in the research group had a higher rate of hematoma clearance than that in the control group(P <0.05).The incidence of complications was 4.6%in the research group and was 12.3%in the control group,and it was statistical different between the two groups(P <0.05).Conclusion:MIPD via improved stereotactic soft-channel was an effective and safe technology for the treatment of HPH,as manifested by a higher rate of hematoma clearance,better neurological function recovery,more simple operation as well as reduced complications in patients.
引文
[1]刘永增.微创硬通道与立体定向软通道治疗高血压脑出血的对比分析[J].哈尔滨医药,2014,34(2):101-102.
[2]吕建华,田力学,郑仕奇,等.硬通道与软通道技术治疗高血压性脑出血临床疗效的比较[J].临床医药实践,2009,18(10):2111-2113.
[3]刘振川,王大明,瞿乐乐,等.高血压性壳核出血微创治疗的临床研究[J].中国脑血管病杂志,2004,1(11):500-502.
[4]叶忠峰.软通道与硬通道微创介入术治疗高血压脑出血综合疗效对比[J].中国当代医药,2011,18(18):242-243.
[5]廖颂明,江焕新,沈伟俊,等.硬通道引流和软通道引流治疗老年高血压脑出血临床疗效对比研究[J].临床医学工程,2013,20(3):294-295.
[6]张龙,漆松涛,冯文峰,等.软、硬通道微创手术治疗幕上高血压脑出血的对比分析[J].中国神经精神疾病杂志,2012,38(8):469-472.
[7]李玉辉,王美清,李东升,等.软、硬通道微创穿刺引流术治疗高血压脑出血的效果比较[J].临床误诊误治,2013,26(3):95-98.
[8]潘均喜,李广汉,韦善,等.三维立体定向软通道与硬通道治疗高血压脑出血疗效比较[J].现代仪器与医疗,2013,19(4):83-87.
[9]NANBA T,OGASAWARA K,NISHIMOTO H,et al.Postoperative cerebral white matter damage associated with cerebral hyperperfusion and cognitive impairment after carotid endarterectomy:a diffusion tensor magnetic resonance imaging study[J].Cerebrovasc Dis,2012,34(5-6):358-367.
[2]吕建华,田力学,郑仕奇,等.硬通道与软通道技术治疗高血压性脑出血临床疗效的比较[J].临床医药实践,2009,18(10):2111-2113.
[3]刘振川,王大明,瞿乐乐,等.高血压性壳核出血微创治疗的临床研究[J].中国脑血管病杂志,2004,1(11):500-502.
[4]叶忠峰.软通道与硬通道微创介入术治疗高血压脑出血综合疗效对比[J].中国当代医药,2011,18(18):242-243.
[5]廖颂明,江焕新,沈伟俊,等.硬通道引流和软通道引流治疗老年高血压脑出血临床疗效对比研究[J].临床医学工程,2013,20(3):294-295.
[6]张龙,漆松涛,冯文峰,等.软、硬通道微创手术治疗幕上高血压脑出血的对比分析[J].中国神经精神疾病杂志,2012,38(8):469-472.
[7]李玉辉,王美清,李东升,等.软、硬通道微创穿刺引流术治疗高血压脑出血的效果比较[J].临床误诊误治,2013,26(3):95-98.
[8]潘均喜,李广汉,韦善,等.三维立体定向软通道与硬通道治疗高血压脑出血疗效比较[J].现代仪器与医疗,2013,19(4):83-87.
[9]NANBA T,OGASAWARA K,NISHIMOTO H,et al.Postoperative cerebral white matter damage associated with cerebral hyperperfusion and cognitive impairment after carotid endarterectomy:a diffusion tensor magnetic resonance imaging study[J].Cerebrovasc Dis,2012,34(5-6):358-367.