摘要：

目的: 探讨新型简易徒手锥颅血肿引流术治疗高血压脑出血的疗效。方法: 共纳入2021年1月至2022年12月安徽医科大学附属亳州医院收治的103例高血压脑出血患者，分别行传统锥颅血肿引流术（传统锥颅组，51例）和新型锥颅血肿引流术（新型锥颅组，52例）。根据手术前后头部CT图像计算血肿清除率，评价引流管置入精准度；采用美国国立卫生研究院卒中量表（NIHSS）评价神经功能缺损程度，改良Rankin量表（mRS）评价神经功能预后。结果: 新型锥颅组血肿清除率[（45.54 ±24.23）%对（35.08 ±6.49）%；t = 3.008，P = 0.004]和引流管置入精准度[90.38%（47/52）对68.63%（35/51）；χ² = 7.509，P = 0.006]均高于传统锥颅组。新型锥颅组与传统锥颅组血肿量（F = 9.157，P = 0.003）和mRS评分（F = 4.412，P = 0.038）差异具有统计学意义，术后新型锥颅组血肿量（t = - 4.625，P = 0.000）和mRS评分（t = - 2.712，P = 0.008）均低于传统锥颅组；两组手术前后血肿量（F = 280.635，P = 0.000）、NIHSS评分（F = 443.320，P = 0.000）和mRS评分（F = 552.781，P = 0.000）差异亦具有统计学意义，新型锥颅组和传统锥颅组术后血肿量（t = 10.233，P = 0.000；t = 19.906，P = 0.000）、NIHSS评分（t = 14.576，P = 0.000；t =15.286，P = 0.000）和mRS评分（t = 20.201，P = 0.000；t = 13.511，P = 0.000）均低于术前。结论: 新型简易徒手锥颅血肿引流术治疗高血压脑出血安全、有效。

关键词: 颅内出血, 高血压性, 血肿, 引流术, 体层摄影术, 螺旋计算机, 神经外科手术

Abstract:

Objective: To explore the efficacy of a novel and hematoma drainage for hypertensive intracerebral hemorrhage. Methods: From January 2021 to December 2022, 103 patients with hypertensive intracerebral hemorrhage at The Affiliated Bozhou Hospital of Anhui Medical University were included. They were treated with traditional bone cone drilling hematoma drainage (traditional group, n = 51) and novel-type bone cone drilling hematoma drainage (novel-type group, n = 52). Based on pre- and post-surgery head CT results, the hematoma clearance rate and accuracy of catheter placement were calculated. National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficits, and modified Rankin Scale (mRS) was used to evaluate the neurological functional prognosis. Results: The hematoma clearance rate in the novel-type group [(45.54 ±24.23)% vs. (35.08 ±6.49)%; t = 3.008, P = 0.004] and the accuracy of catheter placement [90.38% (47/52) vs. 68.63% (35/51); χ² = 7.509, P = 0.006] were significantly higher than those of the traditional group. The novel-type group and the traditional group showed statistically significant differences in hematoma volume (F = 9.157, P = 0.003) and mRS score (F = 4.412, P = 0.038). The postoperative hematoma volume (t =-4.625, P = 0.000) and mRS score (t =-2.712, P = 0.008) of the novel-type group were lower than those of the traditional group. Statistically significant differences were observed in hematoma volume (F = 280.635, P = 0.000), NIHSS score (F = 443.320, P = 0.000) and mRS score (F = 552.781, P = 0.000) before and after surgery in the 2 groups; the hematoma volume (t = 10.233, P = 0.000; t = 19.906, P = 0.000), NIHSS score (t = 14.576, P = 0.000; t = 15.286, P = 0.000) and mRS score (t = 20.201, P = 0.000; t = 13.511, P = 0.000) after operation were lower than those before operation in the 2 groups. Conclusions: The novel and simple manual bone cone drilling hematoma drainage is a safe and effective treatment for hypertensive intracerebral hemorrhage.

Key words: Intracranial hemorrhage, hypertensive, Hematoma, Drainage, Tomography, spiral computed, Neurosurgical procedures