CAJ | 학술논문

目的：探讨定向软通道微创治疗高血压脑出血的临床疗效，进一步评价其应用价值。方法：选取本院收治的90例高血压脑出血患者，根据患者的年龄、血肿、血肿体积大小、术前GCS评分将其分为定向软通道组、定向硬通道组及开颅手术组各30例，术后观察三组患者Barthel指数的区别，并比较3个月后的随访结果。结果：术后三组患者的Barthel指数有效率分别为90.00%、83.33%、80.00%，经过3个月随访后，三组患者的Barthel指数有效率分别为96.67%、86.67%、83.33%（P<0.05），三组患者治疗皆有一定疗效，但最有优势的为定向软通道微创组。同时，三组当中死亡率最低的也是软通道微创组，仅为3.33%，明显低于其他两组，差异均有统计学意义（P<0.05）。结论：定向软通道微创治疗高血压脑出血最大限度地避免传统术式所引起的术后严重脑水肿及术后再出血等并发症，能提高患者的生存几率与生存质量，显著缩短平均住院时间，大幅节省治疗费用，且对仪器设备要求不高，操作更简便，易于大规模推广。
목적：탐토정향연통도미창치료고혈압뇌출혈적림상료효，진일보평개기응용개치。방법：선취본원수치적90례고혈압뇌출혈환자，근거환자적년령、혈종、혈종체적대소、술전GCS평분장기분위정향연통도조、정향경통도조급개로수술조각30례，술후관찰삼조환자Barthel지수적구별，병비교3개월후적수방결과。결과：술후삼조환자적Barthel지수유효솔분별위90.00%、83.33%、80.00%，경과3개월수방후，삼조환자적Barthel지수유효솔분별위96.67%、86.67%、83.33%（P<0.05），삼조환자치료개유일정료효，단최유우세적위정향연통도미창조。동시，삼조당중사망솔최저적야시연통도미창조，부위3.33%，명현저우기타량조，차이균유통계학의의（P<0.05）。결론：정향연통도미창치료고혈압뇌출혈최대한도지피면전통술식소인기적술후엄중뇌수종급술후재출혈등병발증，능제고환자적생존궤솔여생존질량，현저축단평균주원시간，대폭절성치료비용，차대의기설비요구불고，조작경간편，역우대규모추엄。
To investigate the clinical efficacy of directional soft channel minimally invasive in treatment of of hypertensive cerebral hemorrhage,and further to evaluate the application value.Method:90 patients with hypertensive cerebral hemorrhage in our hospital were selected,according to their age,hematoma,hematoma volume size and preoperative GCS score were randomly divided into directional soft channel group,directional hard channel group and the surgical craniotomy,30 cases in each group.The Barthel index difference of three groups were observed, after 3 months of follow-up results were compared.Result:The Barthel index rates of three groups after surgery were 90.00%,83.33%,80.00%,after 3 months of follow-up,the Barthel index rates of three groups after surgery were 96.67%,86.67%,83.33%(P<0.05),three groups of patients all had certain curative effect,but the most advantage was directional soft channel of minimally invasive group,while the lowest mortality among the three groups was soft channel minimally invasive group,only 3.33%,it was significantly lower than the other two groups,the differences were statistically significant(P<0.05).Conclusion:Soft directional channel of minimally invasive treatment of hypertensive cerebral hemorrhage maximally avoid conventional surgery caused by postoperative complications such as severe cerebral edema and postoperative bleeding again,can improve survival and quality of life of patients,shorten hospitalization time,save the cost of treatment,the instrument and equipment requirements is not high,easy operation,easy large-scale popularization.