论文部分内容阅读
目的:探讨微创软通道血肿穿刺引流术治疗中少量基底核区高血压脑出血与保守治疗基底核区高血压脑出血的效果。方法:选取2013年1月至2017年6月滨州市中心医院神经外科收治的164例中少量基底核区高血压脑出血患者，男83例，女81例，年龄(56±8)岁，年龄范围为36～77岁，采用随机数表法将其随机分为传统治疗组与微创治疗组，每组82例。于患者治疗前、治疗后14 d、1个月、3个月及6个月进行神经功能缺损评分(NDS)和日常生活能力评定(ADL)；并对微创治疗组和传统治疗组两组患者在14 d、1个月、3个月及6个月时的病死率、有效率及基本痊愈率进行比较。结果:治疗前两组患者NDS比较，差异无统计学意义(n P>0.05)；微创治疗组在治疗后14 d[(21.17±4.97)分]、1个月[(18.38±5.26)分]、3个月[(12.73±3.98)分]、6个月[(8.67±3.46)分]NDS均优于传统治疗组[(28.14±5.82)分、(26.67±5.03)分、(18.15±4.17)分、(13.19±3.54)分]，差异有统计学意义(n P0.05)；微创治疗组患者在治疗后14 d[(24.34±4.64)分]、1个月[(41.54±4.51)分]、3个月[(80.84±4.36)分]、6个月[(92.29±3.76)分]ADL均优于传统治疗组[(16.26±4.32)分、(20.67±4.63)分、(65.15±4.16)分、(86.86±3.61)分]，差异有统计学意义(n P<0.05)。微创治疗组患者治疗后14 d基本痊愈率[12.2%(10/82)]、有效率[75.6%(62/82)]、病死率[1.2%(1/82)]均优于传统治疗组[3.7%(3/82)、46.3%(38/82)、4.9%(4/82)]患者；治疗后一个月基本痊愈率[19.5%(16/82)]、有效率[84.1%(69/82)]、病死率[2.4%(2/82)]均优于传统治疗组[9.8%(8/82)、74.4%(61/82)、6.1%(5/82)]患者；治疗后三个月基本痊愈率[26.8%(22/82)]、有效率[92.7%(76/82)]、病死率[2.4%(2/82)]均优于传统治疗组[15.9%(13/82)、82.9%(68/82)、6.1%(5/82)]患者；治疗后六个月基本痊愈率[29.3%(2/82)]、有效率[95.1%(78/82)]、病死率[2.4%(2/82)]均优于传统治疗组[18.3%(5/82)、91.5%(75/82)、6.1%(5/82)]患者；差异均有统计学意义(n P0.05). NDS of the minimally invasive treatment group was better than that of the conventional treatment group at 14 days[(21.17±4.97), 1 month[(18.38±5.26)], 3 months[(12.73±3.98)]and 6 months[(8.67±3.46)], with statistically significant differences(n P0.05). The ADL of the minimally invasive treatment group was better than that of the traditional treatment group at 14 days[(24.34±4.64), 1 month[(41.54±4.51)], 3 months[(80.84±4.36)]and 6 months[(92.29±3.76)], with statistically significant differences(n P<0.05). The recovery rate[12.2%(10/82)], the effective rate[75.6%(62/82)], and the death rate[1.2%(1/82)]of the minimally invasive treatment group were all better than those of the traditional treatment group[3.7%(3/82), 46.3%(38/82) and 4.9%(4/82)]. One months after the treatment, the basic recovery rate[19.5%(16/82)], effective rate[84.1%(69/82)]and mortality[2.4%(2/82)]were all better than those in the traditional treatment group[9.8%(8/82), 74.4%(61/82) and 6.1%(5/82)]. Three months after the treatment, the basic recovery rate[26.8%(22/82)], effective rate[92.7%(76/82)]and mortality[2.4%(2/82)]were all better than those in the traditional treatment group[15.9%(13/82), 82.9%(68/82) and 6.1%(5/82)]. After six months of treatment, the basic recovery rate[29.3%(2/82)], the effective rate[95.1%(78/82)], and mortality[2.4%(2/82)]were all better than those in the traditional treatment group[18.3%(5/82), 91.5%(75/82), and 6.1%(5/82)], and the differences were statistically significant(n P<0.05).n Conclusion:Minimally invasive hematoma puncture drainage soft channel can be simple and quick removal of hematoma, short term significantly promote the recovery of neural function in patients with cerebral hemorrhage, reduce the death rate, which is an effective method for treatment of a small amount of basal ganglia hemorrhage.