小骨窗术和碎吸术治疗脑出血的临床应用研究

Clinical study on the therapy effect of intracerebral hemorrhage treated by small bone window aspiration and transcranial stereotactic aspiration.

目的对比研究颅内血肿小骨窗清除术和颅内血肿(钻孔)碎吸清除术治疗脑出血的疗效。方法87例脑出血患者分为小骨窗组(行颅内血肿小骨窗清除术)、碎吸组(行颅内血肿碎吸清除术)和对照组(行内科保守治疗)。分别比较小骨窗组、碎吸组、保守组治疗前后的GCS评分及3组的GCS评分差。采用t检验、χ2检验和单因素方差分析比较。结果小骨窗组、碎吸组与保守组的GCS评分差比较均有差异(P<0.05);小骨窗组和碎吸组的GCS评分差比较也有差异(P<0.05)。结论小骨窗颅内血肿清除术、碎吸颅内血肿清除术、内科保守疗法在脑出血治疗中均能发挥一定的作用。小骨窗术和碎吸术在治疗中均能提高疗效、加快神经功能恢复,但小骨窗术较碎吸术能更好地发挥疗效、提高病人的生存质量。

To study the different therapy effects of intracerebral hemorrhage treated by small bone window aspiration and transcranial stereotactic aspiration. Method 33 cases of group C received conservative medical treatment, 20 cases of group A received craniotomy （small bone window）, and 34 cases of group B received transcranial stereotactic aspiration. Glasgow coma scales of three groups before and after treatment were compared. Result The Glasgow coma scales of group A, B, C before and after treatment were different. The remainders of Glasgow coma scales of three groups were significantly different respectively （P 〈 0.01 ）, the remainders of Glasgow coma scale of group A were significantly different from that of group B （ P 〈 0.05） and group C （ P 〈 0.05）, and group A was significantly different from group B （ P 〈 0.05）. Conclusion （ 1 ） Conservative medical treatment, the transcranial stereotactic aspiration and craniotomy play roles in the therapy of intracerebral hemorrhage. （2） Craniotomy （small bone window） may be better than transcranial stereotactic aspiration about promoting the recovery of neurological function.