微创化手术方式在高龄脑出血患者中的应用

Clinical application of minimally invasive surgery in elderly patients with cerebral hemorrhage

目的探讨微创化手术方式在高龄脑出血患者中的疗效。方法回顾性分析年龄大于65岁高血压脑出血行手术治疗的患者的临床资料，按不同手术方式分为常规组（123例，采用常规骨瓣开颅手术治疗）和微创组（136例，采用微创化手术方式治疗）。术后1个月随访两组患者格拉斯哥预后量表（GOS）评分判定预后。结果微创组预后良好率高于常规组[39．7％（54／136）比29．3％（36／123）]，但差异无统计学意义（P〉0．05）。微创组病死率明显低于常规组[17．6％（24／136）比28．5％（35／123）]，差异有统计学意义（P〈0．05）。结论对高龄脑出血患者采用微创化手术方式，可明显改善患者的预后情况，提高患者的救治率。

Objective To explore the efficacy of minimally invasive surgery in elderly patients with cerebral hemorrhage. Methods Clinical data of hypertensive cerebral hemorrhage patients who were older than 65 years were retrospectively analyzed, and they were divided into two groups by different surgical methods. Regular group： from March 2010 to February 2011, 123 cases of conventional bone window surgery. Minimally invasive group： from March 2011 to February 2012, 136 cases of minimally invasive surgery. One month after surgery, two groups of patients with the scores of Glasgow outcome scale （GOS） to determine the prognosis. Results The better prognosis rate in minimally invasive group was higher than that in regular group [39.7%（54/136） vs. 29.3%（36/123）],but there was no significant difference （P〉 0.05）. The incidence rate of death in minimally invasive group was significantly lower than that in regular group [ 17.6% （24/136） vs. 28.5% （35/123） ], and there was significant difference （P 〈 0.05 ）. Conclusion For elderly patients with cerebral hemorrhage, the minimally invasive surgery can significantly improve the prognosis.