微创医学

目的探讨立体定向软通道微创血肿穿刺外引流术治疗高血压脑出血的临床疗效。方法 64例高血压脑出血患者，按照治疗方法分为定向软通道组（21例）、定向硬通道组（22例）和开颅手术组（21例）。观察记录三组的Barthel指数总疗效和住院时间，并进行比较。结果术后7 d和术后3个月，分别对三组患者进行Barthel指数总疗效分析，定向软通道组的总有效率与定向硬通道组和开颅手术组比较，差异均有统计学意义（均P＜0.05）。定向软通道组的住院时间为（19.21±2.01）d，与硬通道组［（24.51±3.15）d］和开颅手术组［（29.87±5.73）d］比较，差异均有统计学意义（均P＜0.05）。结论应用立体定向软通道微创血肿穿刺外引流术治疗高血压脑出血可以有效改善患者的日常生活能力，缩短住院时间，获得良好的临床疗效。

Objective To investigate the clinical efficacy of minimally invasive stereotactic soft channel hematoma puncture and drainage for hypertensive intracerebral hemorrhage. Method A total of 64 patients with hypertensive cerebral hemorrhage were divided into directional soft channel group (n=21), directional hard channel group (n=22) and craniotomy group (n=21) according to the treatment method. The efficacy assessed by Barthel index and the hospital stays were recorded and compared between the two groups. Results At 7 days and 3 months after surgery, the efficacy of the three groups was assessed by Barthel index. There was a difference in the total effective rate in the directional soft channel group compared with the directional hard channel group and the craniotomy group (P＜0.05 for all variables). There was a difference in the hospital stay in the directional soft channel group ［(19.21 ± 2.01) d］ compared with the directional hard channel group ［(24.51±3.15) d］ and the craniotomy group ［(29.87±5.73) d］ (P＜0.05 for all variables). Conclusion For the patients with hypertensive cerebral hemorrhage, minimally invasive stereotactic softchannel hematoma puncture and drainage can improve activities of daily living, reduce the hospital stay and offer good clinical efficacy.