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[目的]评价高血压脑出血微创穿刺引流术后早期康复治疗的临床疗效。[方法]600例高血压脑出血病人按2︰1比例分为治疗组与对照组,治疗组采用微创血肿清除术同时加早期康复治疗;对照组为传统骨瓣开颅术。比较两组治疗后的临床疗效、血肿清除率、手术后GCS评分及SSS评分,采用简式(Fugl-Meyer,FM)评价方法评定治疗前后肢体运动功能、巴氏指数(BI)评定生活自理能力、Rankin分级进行评定生活质量,并进行统计学分析。[结果]临床疗效治疗组总有效率为97.75%,病死率为1.25%;对照组总有效率为85.00%,病死率为12.50%。两组比较,差异有统计学意义(P﹤0.01);治疗组血肿清除病例及并发症发生病例与对照组比较,差异有统计学意义(P﹤0.01);两组术后7dGSS评分及术后14d、30dSSS评分、肢体运动功能评分、日常生活活动评分及生活质量评价等方面比较,差异有统计学意义(P﹤0.05)。[结论]微创穿刺术是一种治疗高血压性脑出血的安全有效的方法,结合早期康复治疗能提高高血压脑出血病人的临床疗效,降低病死率,早期行康复治疗能促进肢体运动功能、神经功能缺损程度恢复,提高病人生活自理能力及生活质量,值得临床推广和应用。
[Objective] To evaluate the clinical effect of early rehabilitation after minimally invasive puncture and drainage of hypertensive intracerebral hemorrhage. [Method] 600 hypertensive intracerebral hemorrhage patients were divided into treatment group and control group according to the ratio of 2︰1. The treatment group was treated with minimally invasive hematoma removal and early rehabilitation treatment. The control group was treated by traditional bone flap craniotomy. The curative effect, hematoma clearance rate, postoperative GCS score and SSS score were compared between the two groups. Fugl-Meyer (FM) evaluation method was used to assess the limbs motor function before and after treatment. The Barthel Index (BI) Rankin was graded to assess the quality of life and to conduct a statistical analysis. [Results] The total effective rate of clinical curative effect group was 97.75% and the case fatality rate was 1.25%. The total effective rate of the control group was 85.00% and the case fatality rate was 12.50%. The differences between the two groups were statistically significant (P <0.01). There was significant difference between the treatment group and the control group (P <0.01) 14d, 30dSSS score, limb motor function score, activities of daily living and quality of life evaluation, the difference was statistically significant (P <0.05). [Conclusion] Minimally invasive puncture is a safe and effective method for the treatment of hypertensive intracerebral hemorrhage. Combined with early rehabilitation can improve the clinical curative effect and reduce the mortality of patients with hypertensive intracerebral hemorrhage. Early rehabilitation can promote limb motor function , The degree of neurological deficit recovery, improve patient self-care ability and quality of life, it is worth clinical promotion and application.