高血压脑出血超早期手术开颅小骨窗优选设计的临床研究

Clinical study of optimal design of small bone window in hypertensive intracerebral hemorrhage during ultra-early period

目的探讨黄金分割法及其简易计算法两者在高血压脑出血开颅骨窗设计中应用的临床价值。方法对高血压脑出血76例病人,随机分成2组,分别应用黄金分割法及其简易计算法,观察两组病人年龄、术前神经学症状分期、术前合并脑疝情况、术前脑出血量、头颅CT中线结构移位、术后残余血肿及预后有否差异。结果两种方法界定的骨窗,治疗效果在统计学上无明显差异。结论黄金分割法在高血压脑出血骨窗界定中具有较高的实用价值,由其结果推得的简易计算法:骨窗大小=(头颅CT最大血肿层长径×1/2)2,实用性强,方便易记,更便于推广应用。

Objective To study the clinical value of the two methods, the golden section method and the simplified method, which were used to evaluate the bone window size during ultra-early period of hypertensive intracerebral hemorrhage. Methods 76 patients with hypertensive intracerebral hemorrhage were randomly divided into 2 groups and operated via small bone windows, of which the size was calculated by the golden section method and the simplified method respectively. The following parameters of the two groups were observed: age, preoperative neurological stage, cerebral hernia, quantity of preoperative cerebral hemorrhage, shift of midline structures, the quantity of postoperative remnant hemorrhage, and prognosis etc. Results The therapeutic efficacies via the small bone window calculated by the two different ways have no significantly statistical difference. Conclusion Bone window size measured through the golden section method in hypertension intracerebral hemorrhage have a high practical value. The simplified method is originated from the golden section method and the bone window size =(the maximum hematoma's diameter of CT × 1/2)2. It is finely practical, easy to remember, and convenient to spread and use.