基底节区脑出血保守治疗与手术治疗的疗效对比

刘俊耀

[摘要] 目的 對基底节区脑出血保守治疗与手术治疗方式以及疗效进行详细探究。方法 该次研究方便选取2016年11月—2017年11月该院收治的40例基底节区脑出血患者作为研究对象，根据治疗方式不同，将所有患者分为对照组20例以及观察组20例。对于对照组患者，采用保守治疗方案，对于观察组患者，采用经外侧裂入路显微手术治疗方案。根据NIHSS评分减分率，对患者近期治疗效果进行统计和比较；对两组患者死亡率、不良事件发生情况等进行统计和比较。结果 观察组患者VIHSS评分为（7.6±1.6）分，Barthel指数为（74.2±6.7）分，对照组患者VIHSS评分为（13.0±2.3）分，Barthel指数为（55.4±4.6）分。观察组患者在VIHSS评分及Barthel指数这两个方面均明显优于对照组患者，组间差异有统计学意义（t=6.865 5、7.789 6，P<0.05）。观察组患者中，有2例患者出现不良事件，发生率为10.0%，对照组患者中，有6例患者出现不良事件，发生率为30.0%，观察组患者不良事件发生率明显低于对照组患者，组间差异有统计学意义（χ2=12.632 1，P<0.05）。结论 与保守治疗相比，采用手术治疗方式，能够有效改善基底节区脑出血患者临床症状，促进预后，提高患者日常生活活动能力。

[关键词] 基底节区脑出血；保守治疗；穿刺；引流；疗效

[中图分类号] R743.34 [文献标识码] A [文章编号] 1674-0742（2018）05（a）-0065-03

Comparison of Curative Effect of Conservative Therapy and Operative Therapy of Basal Ganglia Intracerebral Hemorrhage

LIU Jun-yao

Department of Neurosurgery， Xuanwei First Peoples Hospital， Xuanwei， Yunnan Province， 655400 China

[Abstract] Objective To study the curative effect of conservative therapy and operative therapy of basal ganglia intracerebral hemorrhage. Methods 40 cases of patients with basal ganglia intracerebral hemorrhage admitted and treated in our hospital from November 2016 to November 2017 were convenient selected and divided into two groups with 20 cases according to different treatment methods， the control group used the conservative treatment plan， while the observation group were treated with microsurgery for lateral fissure approach， and the short-term treatment effect was counted and compared according to the decrease rate of NIHSS score， and the morbidity， and occurrence of adverse events were counted and compared between the two groups. Results The VIHSS score， Barthel index in the observation group were obviously better than those in the control group， [（7.6±1.6）points， （74.2±6.7）points vs （13.0±2.3）points， （55.4±4.6）points]， and the differences were statistically significant（t=6.865 5，7.789 6， P<0.05） ， and in the observation group， there were 2 cases with adverse events， and the incidence rate was 10.0%， and in the control group， there were 6 cases with adverse events， and the incidence rate was 30.0%， and the incidence rate of adverse events was obviously lower than that in the control group， and the differences were statistically significant （χ2=12.632 1，P<0.05）. Conclusion The operative therapy can more effectively improve the clinical symptoms of patients with basal ganglia intracerebral hemorrhage compared with that of conservative therapy， thus promoting the prognosis and improving the Barthel.

[Key words] Basal ganglia intracerebral hemorrhage； Conservative therapy； Puncture； Drainage； Curative effect

高血压脑出血为临床常见高血压严重并发症之一，具有发病率高、起病急、病情重、致残致死率高等特点，多发于小脑、脑干、大脑基底节等部位，其中以基底节部位最为常见，约占高血压脑出血的60%。基底节区脑出血极易引发轻偏瘫、痫性发作等症状，严重者甚至出现意识模糊、昏迷等症状，危及患者生命安全[1]。在对基底节区脑出血患者进行治疗时，注意有保守治疗和手术治疗两种方式，其中，手术为目前临床治疗基底节区脑出血首选方案，可有效清除血肿，改善患者临床症状。在该次研究中，方便选取该院2016年11月—2017年11月收治的基底节区脑出血患者40例，对保守治疗与手术治疗临床疗效进行对比分析，现报道如下。……