小骨窗开颅治疗高血压基底节脑出血76例临床分析

Investigation of the Small bone Window Craniotomy Surgery to Remove Different GCS Grading Hypertension Cerebral Hemorrhage Hematoma

目的：探讨小骨窗开颅术清除不同GCS分级高血压脑出血后血肿的治疗效果。方法：将76例基底节高血压脑出血患者，依据GCS评分分为3级：1级为12～15分；2级为8～11分；3级为3～7分。对不同GCS分级患者均采用小骨窗开颅血肿清除术，总结手术要点，并对术后疗效进行评估。结果：76例患者，GCS分级1级占30．26（23/76），2级占47．37％（36/76），3级占21．05％（16/76）。采用小骨窗开颅清除血肿后，根据GOS评分：1级恢复良好者20例，中残2例，重残1例；2级恢复良好者16例，中残13例，重残4例，植物生存2例，死亡1例；3级恢复良好者2例，中残5例，重残4例，植物生存，3例，死亡2例。结论：小骨窗开颅清除血肿对不同GCS分级患者预后影响不同，具有血肿清除可靠、再出血概率小、住院时间短、费用低等优点。

objective：To investigate the small bone window craniotomy surgery to remove different GCS grading hypertension cerebral hemorrhage hematoma after effective treatment .Methods：76 patients with hypertensive cerebral hemorrhage in basal ganglia , GCS score based on three levels：level 1 to 12 or 15 points; Level 2 is 8 ~11 points;Level 3 for 3 ~7 points.For different patients with GCS grading are used for removal of small bone window craniotomy hematoma , summarize the main points surgery ,and to evaluate postoperative curative effect.Results：76 patients, GCS grading 1 level of 30.26 （23/76）, 2 levels of 47.37% （36/76）, 3 （21.05%） （16/76）.By small bone window craniotomy to clear hematoma after , according to GOS scores：1 fluent speaking and written level recovery , 20 patients with residual in 2 cases, heavy damage in 1 case;2 fluent speaking and written level recovery in 16 cases, 13 cases, 4 cases were severely disabled, plant survival in 2 cases, 1 case death;Fluent speaking and written 3 level recovery in 2 cases, in 5 cases, 4 cases were severe-ly disabled, plant survival, 3 cases, 2 cases died.Conclusion：small bone window craniotomy to clear hematoma effect on the prognosis of patients with different GCS grading is different , has the advantage of reliable ,and bleeding probability is small , shorter hospitalization time and lower cost.