小骨窗微创开颅术治疗高血压脑出血的疗效观察

The curative effect of minimally invasive small bone window treatment on hypertensive intracerebral hemorrhage

目的观察小骨窗开颅手术治疗高血压脑出血的临床疗效。方法将58例高血压脑出血患者随机分为观察组30例和对照组28例。观察组采用小骨窗开颅术治疗,对照组采用内科保守治疗,观察并对比两组的临床疗效,神经功能恢复情况及预后情况。结果观察组30例患者首次清除血肿量均达到60%以上。观察组总有效率为86.7%,对照组总有效率为67.9%,两组总有效率均比较,差异有统计学意义(P<0.05)。两组患者治疗前神经功能缺损评分,差异无统计学意义(P>0.05);观察组治疗前后神经功能缺损评分差值明显高于对照组,差异有统计学意义(P<0.05);两组治疗3个月后GOS评分比较,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论小骨窗开颅术治疗高血压脑出血疗效显著,具有血肿清除率高、神经功能恢复良好、预后良好等优点,值得临床推广应用。

Objective To observe the clinical efficacy of small bone window craniotomy for the treatment of hypertensive intracerebral hemorrhage.Methods 58 patients with hypertensive cerebral hemorrhage were randomly divided into observation group（30 cases） and control group（28 cases）.Patients of the observation group were treated with small bone window craniotomy treatment,while patients of the control group with conservative treatment,the clinical efficacy,nerve function recovery and prognosis of the two groups were observed and contrasted.Results More than 60% hematoma for the first time were removed in 30 patients of the observation group.The total effective rate of the observation group and the control group were 86.7%,,and 67.9% individually,and the difference was statistically significant（P0.05）.There were no statistical significance between the two group on neurologic deficit score before treatment（P 0.05）;but after treatment,neurologic deficit score of the observation group was significantly higher than that of the control group（P0.05）.After 3 months of treatment,GOS score of observation group was significantly higher than that of the control group,and the difference was statistically significant（P0.05）.Conclusion Small bone window craniotomy is effective for treating hypertensive intracerebral hemorrhage with high hematoma clearance rate,good recovery of neurological function and the prognosis,which is worthy of clinical application.