小骨窗入路显微外科治疗高血压基底核区脑出血51例临床疗效观察

CLINICAL OBSERVATION OF SMALL WINDOW CRANIOTOMY IN THE TREATMENT OF ROAD MICROSURGERY FOR HYPERTENSIVE BASAL GANGLIA OF 51 CASES OF CEREBRAL HEMORRHAGE

目的研究小骨窗入路显微外科治疗高血压基底核区脑出血的临床效果,为临床高血压基底脑出血的治疗提供依据。方法对入院治疗的102例患者进行研究,随机分为二组,对照组采用常规骨瓣开颅手术,观察组采用小骨窗入路显微外科治疗,比较二组患者GCS评分、溃疡及癫的发生率,二组患者手术时间、血肿清除率以及术后再出血率,比较二组患者脑梗死、脑积液等并发症的发生率,并对二组患者日常生活能力进行评分比较。结果观察组患者术后24h GCS评分明显高于对照组,癫及溃疡的发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患者手术时间明显低于对照组,血肿清除率以及术后再出血率明显低于对照组,差异有统计学意义(P<0.05);观察组患者脑梗死、脑积液、肺部感染等并发症的发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患者生活能力良好率为80.4%,明显高于对照组54.9%,二组比较差异有统计学意义(P<0.05)。结论小骨窗入路显微外科治疗高血压基底核区脑出血临床效果显著,手术操作时间更短,患者并发症更少,患者恢复生活能力的良好率更高,值得临床推广应用。

Objective To study the clinical effect of small bone window into road microsurgical hypertension of basal ganglia hemorrhage ,provide the basis for clinical treatment of hypertensive basal cerebral hemor‐rhage .Methods From April 2010 to January 2012 in 102 cases of patients in our hospital inhospital treat‐ment were studied ,and were randomly divided into two groups ,the control group with routine craniectomy 〈br〉 operation ,treatment group were treated with small bone window in the treatment of road microsurgery ,oc‐currence rate were compared between the two groups in GCS score ,ulcer and epilepsy ,two groups of pa‐tients with operation time ,hematoma clearance rate and postoperative rebleeding rate ,incidence compared two groups of patients with cerebral infarction ,the incidence of hydrocephalus ,and the ability of daily life of patients in the two groups were compared .Results In the treatment group ,patients with postoperative GCS score was significantly higher than that in the control group ,epilepsy and ulcer incidence was signifi‐cantly lower than that of the control group ,the difference was statistically significant （P〈0 .05） .The pa‐tients in the treatment group were significantly lower than those in the control group ,operation time ,he‐matoma clearance rate and postoperative rebleeding rate were significantly lower than that in the control group ,the difference was statistically significant （P〈0 .05） .The patients with cerebral infarction ,hydro‐cephalus ,lung infection and other complication rates were significantly lower in the treatment group than those in the control group ,the difference was statistically significant （P〈0 .05） .The patients in the treat‐ment group were living the good rate was 80 .4% ,significantly higher than that of the control group 54 . 9% ,the difference between the two groups was with statistical significance （P〈0 .05） .Conclusion Small bone window in the treatment of road microsurgical hypertensive basal ganglia hemorrhage clinical effect is remarkable with shorter operation time ,less complications ,higher rate of patients recover life ability ,it is worthy of clinical application .