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小骨窗开颅血肿清除引流术与微创穿刺碎吸引流术在脑出血早期凝血功能异常患者中的疗效比较

Removal and drainage of hematoma by small bone window craniotomy versus minimally invasive puncture and aspiration in treatment of cerebral hemorrhage patients with coagulation disorders in early stage

    摘要
  • 摘要:
      目的  比较小骨窗开颅血肿清除引流术与微创穿刺碎吸引流术治疗脑出血早期凝血功能异常患者的疗效。
      方法  选取本院2009年3月—2018年3月脑出血早期凝血功能异常患者84例, 随机分为观察组与对照组各42例。对照组应用小骨窗开颅血肿清除引流术治疗，观察组应用微创穿刺碎吸引流术治疗，比较2组治疗效果。
      结果  观察组近期疗效显著优于对照组(P < 0.05)。术后6个月，观察组中26例患者生活可自理，占63.41%; 对照组中仅13例患者可自理，占35.14%, 差异有统计学意义(P < 0.05)。观察组血肿吸收时间为(12.17±2.24) d，短于对照组(28.41±4.39) d; 观察组神经功能缺损评分为(9.58±2.03)分，低于对照组的(16.57±3.14)分，差异均有统计学意义(P < 0.05)。观察组血肿再发率为16.67%, 显著低于对照组的38.10%(P < 0.05)。
      结论  采用微创穿刺碎吸引流术治疗脑出血凝血功能异常者安全、有效，具有操作简单、创伤小、术后恢复快等优势。

     

    Abstract:
      Objective  To compare the efficiency of removal and drainage of hematoma by small bone window craniotomy versus minimally invasive puncture and aspiration in treatment of cerebral hemorrhage patients with coagulation disorders in early stage.
      Methods  From March 2009 to March 2018, 84 cerebral hemorrhage patients with coagulation disorders in early stage were randomly divided into observation group and control group, with 42 cases in each group. The control group was treated with removal and drainage of hematoma by small bone window craniotomy, while the observation group was treated with minimally invasive puncture and aspiration. The efficiency was compared between two groups.
      Results  The short-term effect of the observation group was significantly better than that of the control group (P < 0.05). Six months after operation, 26 patients in the observation group could take care of themselves, accounting for 63.41%, but only 13 patients in the control group did, accounting for 35.14%, and there was a significant difference (P < 0.05). The absorption time of hematoma in the observation group was (12.17±2.24) days, which was significantly shorter than (28.41±4.39) days in the control group (P < 0.05). The neurological deficit score in the observation group was (9.58±2.03) points, which was significantly lower than (16.57±3.14) points in the control group (P < 0.05). The recurrence rate of hematoma in the observation group was 16.67%, which was significantly lower than 38.10% in the control group (P < 0.05).
      Conclusion  Minimally invasive puncture and aspiration is safe and effective in the treatment of cerebral hemorrhage patients with abnormal coagulation function, which has the advantages of simple manipulation, small trauma and quick postoperative recovery.

     

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