摘要
目的比较血肿清除去骨瓣手术和保守治疗对高血压脑出血的疗效。方法回顾性分析焦作市第六人民医院2018年5月至2022年4月收治的76例高血压脑出血患者的临床资料,结合不同治疗方式分成对照组40例(保守治疗)和观察组36例(血肿清除去骨瓣手术),比较两组在不同治疗方法下的治疗有效率;下床活动、血肿消除、住院时间和住院费用;治疗前后的神经功能缺损量表(NIHSS)及日常活动能力量表(ADL)得分;治疗前后基质金属蛋白酶-9(MMP-9)水平;并发症发生情况。结果观察组治疗有效率高于对照组,差异有统计学意义(P<0.05)。观察组下床活动、血肿消除及住院时间短于对照组,差异有统计学意义(P<0.05),住院费用多于对照组,差异有统计学意义(P<0.05)。治疗前,两组NIHSS及ADL得分、MMP-9水平相比,差异无统计学意义(P>0.05);治疗后,两组NIHSS得分、MMP-9水平均较前降低,差异有统计学意义(P<0.05),ADL得分均较前升高,差异有统计学意义(P<0.05),且观察组NIHSS得分、MMP-9水平低于对照组,差异有统计学意义(P<0.05),ADL得分高于对照组,差异有统计学意义(P<0.05)。观察组肺部感染、尿路感染、下肢静脉血栓和脑疝等并发症出现少于对照组,差异有统计学意义(P<0.05)。结论和保守治疗相比,血肿清除去骨瓣手术对高血压脑出血疗效更佳,血肿清除术后恢复较快,能改善患者的神经功能和日常活动能力,减少各类并发症出现,值得采用。
Objective To compare the clinical effectiveness of intracranial hematoma removal with decompressive craniectomy or conservative treatment in hypertensive cerebral hemorrhage patients.Methods Clinical data about 76hypertensive cerebral hemorrhage patients treated in our hospital from May 2018 to April 2022 were retrospectively analyzed.According to different therapies,patients were divided into control group(N=40,conservative treatment)and observation group(N=36,intracranial hematoma removal with decompressive craniectomy).The group comparison results were analyzed through the total effective rate,out-of-bed activity time,hematoma removal time,hospital stays,hospitalization costs,national institute of health stroke scale(NIHSS),activity of daily living(ADL)scores,matrix metalloproteinase-9(MMP-9)before and after treatment and treatment complications.Results The total effective rate in the observation group was higher than control group,with statistically significant difference(P<0.05);The out-of-bed activity time,hematoma removal time,hospital stays in the observation group were shorter than control group,with statistically significant differences(P<0.05);The hospitalization cost in the observation group was higher than control group,with statistically significant difference(P<0.05);Before treatment,there were no significant between-group differences about NIHSS,ADL scores and MMP-9 level(P>0.05);After treatment,NIHSS score and MMP-9 level in two groups were significantly lower than before,with statistically significant differences(P<0.05);ADL score in two groups was higher than before,with statistically significant difference(P<0.05);NIHSS score and MMP-9 level in the observation group were even lower than control group,with statistically significant differences(P<0.05);ADL score in the observation group was even higher than control group,with statistically significant difference(P<0.05);The treatment complications like pulmonary infection,urinary tract infection,lower limb vein thrombosis and cerebral hernia in the observation group were significantly fewer than control group,with statistically significant differences(P<0.05).Conclusion By comparison to conservative treatment,the intracranial hematoma removal with decompressive craniectomy can better increase the clinical effectiveness,promote the postoperative recovery,improve the neurological function and daily living activity for hypertensive cerebral hemorrhage patients and reduce the occurrence of various complications,it is worth adopting..
作者
周东丰
ZHOU Dongfeng(Department of Neurosurgery,Jiaozuo Sixth People’s Hospital,Jiaozuo Henan 454000,China)
出处
《临床研究》
2022年第11期42-45,共4页
Clinical Research
关键词
高血压脑出血
保守治疗
血肿清除去骨瓣手术
并发症
hypertensive cerebral hemorrhage
conservative treatment
intracranial hematoma removal with decompressive craniectomy
complications
