小骨瓣开颅和小骨窗开颅手术治疗高血压脑出血78例临床对比研究

THE CONTRAST STUDY OF 78 PATIENTS WITH HYPERTENSIVE CEREBRAL NEMORRHAGE BY SMALL TRAUMA CRANIOTOMY AND KEYHOL E

目的:探讨小骨瓣开颅和小骨窗开颅手术治疗高血压脑出血的外科治疗方法及相关性问题,比较其优缺点,以期获得最佳治疗效果,最大限度地减少死亡率和致残率。方法:分析78例高血压脑出血患者的临床资料,分析手术适应证、手术时机、手术方案及并发症处理等,采取骨瓣开颅和小骨窗开颅两种手术方法,比对治疗效果。结果:78例高血压脑出血患者中,骨瓣开颅48例,治愈42例,占87.5%,死亡1例,占2.08%,自动离院5例,占10.42%。;小骨窗开颅30例,治愈27例,占90%,死亡1例,占3.33%自动离院2例,占6.67%。结论:高血压脑出血外科手术效果良好,合理掌握手术适应证、把握手术时机,尤其超早期手术效果明显。采用小骨瓣开颅和小骨窗开颅手术,效果各具优缺点,而小骨瓣开颅更具灵活性。

Objective：to study the surgicaL therapy and dependabLity of the hypertensive cerebraL hemorrhage by smaLL trauma craniotomy and keyhoLe for the purpose of receiving best therapeutic efficacy and reducing the mortaLity and morbidity.Methods：AnaLysis the cLinicaL data of the 78 patients with hypertensive cerebraL hemorrhage admitted in our hospitaL.AnaLysis indicatio of surgery,time of surgery,surgicaL modaLities and treatment of compLication,compare therapeutic efficacy between keyhoLe and smaLL trauma craniotomy.Results：a group of 48 patients with smaLL trauma craniotomy,42 cases of good recovery（87.5%）,1 cases of dead（2.08%）,5 cases of giving up（10.42%） in smaLL trauma craniotomy group;a group of 30 patients with keyhoLe,27cases of good recovery（90%）,1 cases of dead（3.33%）,2 cases of give up（6.67%） in keyhoLe group.Conclusion：The outcome after surgery of the hypertensive cerebraL hemorrhage were good by master indicatio of surgery,time of surgery reasonabLy,especiaLLy earLier period operation.The effect was different between smaLL trauma craniotomy and keyhoLe,and the keyhoLe was more fLexible.