小骨窗微创手术治疗高血压脑出血并脑疝的疗效分析

Analysis on the Therapeutic Effect of Small Bone Window Craniotomy Operation in the Treatment of Hypertensive Cerebral Hemorrhage with Cerebral Hernia

目的探讨小骨窗微创手术治疗高血压脑出血并脑疝患者的疗效。方法入选我院2012年2月至2013年2月收治的高血压脑出血并脑疝患者48例,根据入院单双日分为观察组和对照组,每组各24例,观察组采用小骨窗微创手术治疗,对照组采用CT定位血肿穿刺术治疗,比较两组再出血率、死亡率和术后日常生活能力。结果观察组手术全部成功,无一例发生再出血,显著优于对照组,差异具有统计学意义(P<0.05);观察组住院期间死亡率为4.2%(1/24),显著低于对照组25.0%(6/24),差异具有统计学意义(P<0.05);术后6个月,观察组ADL评分(59.9±16.8)分显著高于对照组(49.7±15.3)分,差异具有统计学意义(P<0.05)。结论高血压脑出血并脑疝患者采用小骨窗微创手术治疗成功率高,死亡率低,近期预后好。

Objective To investigate the therapeutic effect of small bone window minimally invasive operation in the treatment of hypertensive cerebral hemorrhage with cerebral hernia. Methods 48 patients with hypertensive cerebral hemorrhage and cerebral hernia in our hospital from February 2012 to February 2013 were selected and divided into observation group and control group, with 24 cases in each group. The observation group was treated with small bone window craniotomy operation, while the control group used CT positioning hematoma puncture treatment. The recurrent bleeding rate, mortality and activity of daily living after therapy were compared between two groups. Results All cases in the observation group had successful operation, without case of recurrent bleeding, which was superior to the control group （P〈0.05）. The mortality during hospitalization was 4.2% （1/24） in the observation group, significantly lower than 25.0% （6/24） in the control group （P 〈0.05）. Six months after operation, the ADL score was （59.9 ±16.8） in the observation group, significantly higher than （49.7 ±15.3） in the control group （P 〈0.05）. Conclusions Small bone window minimally invasive operation in the treatment of hypertensive cerebral hemorrhage with cerebral hernia has high success rate and low mortality with good short-term prognosis.