| 韩繁龙 张国来 吴生贵 周志武 韩雪萍.小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血的疗效分析[J].,2016,16(33):6542-6545 |
| 小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血的疗效分析 |
| Efficacy of Small Bone Window Craniotomy and Large Bone FlapCraniotomy in the Treatment of Hypertensive Cerebral Hemorrhage |
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| DOI： |
| 中文关键词: 小骨窗开颅血肿清除术 高血压脑出血 神经功能 |
| 英文关键词: Small bone window craniotomy Hypertensive cerebral hemorrhage Nerve function |
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| 中文摘要: |
| 目的：探讨小骨窗开颅血肿清除术与大骨瓣开颅血肿清除术治疗高血压脑出血的疗效。方法：选取120 例高血压脑出血患
者，分为两组，对照组(60 例)给予大骨瓣开颅血肿清除术，观察组(60 例)给予小骨窗开颅血肿清除术。观察并记录患者围手术期
指标，术前术后6 个月神经功能缺损情况，术后6 个月生活能力及随访12个月期间并发症、死亡例数情况，对比两种手术方法治
疗高血压脑出血的疗效。结果：经小骨窗开颅血肿清除术治疗，观察组患者手术时间，术中输血量，住院时间均明显短于或少于采
用大骨瓣开颅术治疗的对照组患者(P<0.05)，但两组患者在血肿清除率上相比，差异没有统计学意义(P>0.05)。术前两组NIHSS 评
分相比，差异没有统计学意义(P>0.05)。术后6 个月，两组NIHSS 评分均明显降低，且观察组分值更低(P<0.05)，术后6 个月，观察
组ADL评分为17.24± 3.52，对照组ADL评分为22.73± 5.67，观察组ADL评分明显低于对照组(P<0.05)。随访期间，两组死亡率
相比较，差异没有统计学意义(P>0.05)；并发症发生率方面相比较，观察组更低(P<0.05)。结论：小骨窗开颅血肿清除术对高血压脑
出血具有较好的治疗效果，手术创伤小，神经功能影响小，能提高患者生活能力，术后并发症较少，值得临床推广使用。 |
| 英文摘要: |
| Objective:To discuss the efficacy of small bone window craniotomy and large bone flap craniotomy in the treatment
of hypertensive cerebral hemorrhage.Methods:120 patients with hypertensive cerebral hemorrhage were selected, and they were randomly
divided into two groups. The observation group (60 cases) was given small bone window craniotomy. The control group (60 cases)
was given large bone flap craniotomy. The clinical efficacy was evaluated by perioperative indicators, neurological deficit situation before
and after 6 months surgery, living ability and complications and death during 12 months follow-up.Results:After treated by small
bone window craniotomy, the surgical time, intraoperative blood transfusion volume, hospitalization of the observation group were shorter
and less than that of the control group (P<0.05). But there were no statistical significance on hematoma clearance rate between two
groups (P>0.05). There were no statistical significance on NIHSS score between two groups before surgery (P>0.05). After 6 months
surgery, the NIHSS score of two groups were decreased (P<0.05). And the NIHSS score of the observation group was lower than that of
the control group (P<0.05). After 6 month surgery, the ADL score of observation group was 17.24± 3.52, and the ADL score of control
group was 22.73± 5.67, and the ADL score of the observation group was significantly lower than that of the control group(P<0.05). During
the follow-up period, there were no statistical significance on the mortality between two groups (P>0.05). The complications rate of
the observation group was lower than that of the control group (P<0.05).Conclusion:The small bone window craniotomy has a good
therapeutic effect on the hypertensive cerebral hemorrhage with small trauma and little postoperative complications, which can improve
good improvement the living ability and has no great effect on nerve function, worthy of the clinical use. |
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