微创穿刺与开颅治疗高血压脑出血疗效观察

Comparison of minimally invasive treatment with craniotomy in the treatment of hypertensive cerebral hemorrhage

目的探讨微创穿刺与开颅治疗高血压脑出血的方法和疗效,为临床治疗提供指导。方法分析本院2010年1月至2010年6月收治入院的120例高血压脑出血患者资料。采用随机抽取法分为两组,实验组60例,行微创穿刺治疗;对照组60例,行小骨窗开颅治疗。随访6个月～1年,比较两组患者术后疗效、并发症和死亡情况。结果随访期间两组相比,实验组患者手术时间、住院时间、导管拔除等术后即时疗效均明显优于对照组,差异有统计学意义(P<0.05);实验组患者的死亡率、并发症发生率、ADL分级等术后1年疗效与对照组相比,差异无统计学意义(P>0.05)。结论应用微创穿刺与开颅治疗治疗高血压脑出血均可显著提高疗效,但开颅术血肿清除率高,引流术手术时间较短,利于深部血肿的清除,且安全性高,临床使用时应根据患者实际情况选用。

Objective To explore the effect of minimally invasive treatment and craniotomy in the treatment of hypertensive cerebral hemorrhage,and provide guidance for clinical treatment.Methods 120 patients with hypertensive cerebral hemorrhage from January 2010 to June 2010 were analyzed retrospectively,and were randomly divided into two groups,60 patients in the experimental group underwent minimally invasive treatment,and 60 patients in control group,underwent craniotomy in the treatment of small bone window.All the cases in two groups had been followed up for 6 months-1 year,and the efficacy and postoperative complications,occurrence of death in two groups were compared.Results During follow-up,operative time,hospital stay,postoperative catheter removal and other immediate effects in the experimental group were better than those in the control group,with the statistically significant difference（P0.05）;compared with the control group,the mortality,morbidity,ADL grading effect after 1 year in the experimental group had no statistically significant difference.Conclusion The minimally invasive treatment and craniotomy can significantly improve the efficacy in the treatment of hypertensive cerebral hemorrhage,but the minimally invasive treatment had higher craniotomy hematoma rate,shorter operative drainage,conducive to deeper hematoma removal,and safer clinical use.