改良小骨窗手术治疗高血压基底节区脑出血临床分析

Clinical analysis of improved small bone window in treatment of basal ganglia hemorrhage in patients with hypertension

目的 探讨在高血压基底节区脑出血治疗中应用改良小骨窗术的临床疗效及安全性.方法 选取2011年4月至2013年4月运城市中心医院心脑血管科门诊收治的82例高血压基底节区脑出血患者作为研究对象,随机分为实验组和对照组,实验组采用改良小骨窗手术治疗,对照组实施传统的小骨窗手术.比较两组术后的血肿清除效果并评价生活能力.结果 实验组42例患者中32例全部清除,7例大部分清除,总有效率为92.9％,死亡3例;对照组40例患者中21例全部清除,12例大部分清除,总有效率为82.5％,死亡7例.两组上述指标比较差异有统计学意义（P＜0.05）.术后随访实验组总体治疗效果显著优于对照组（P＜0.05）.结论 改良小骨窗手术治疗高血压基底节区脑出血疗效确切,安全可靠,并发症少,能明显改善患者术后生存质量,值得临床推广应用.

Objective To investigate the clinical efficacy and safety of improved small bone window operation in treatment of hypertensive cerebral hemorrhage in basal ganglia for patients with hypertension.Methods Eighty-two patients with hypertensive cerebral hemorrhage in basal ganglia from April 2011 to April 2013 in Yuncheng central hospital were selected as research subjects.All patients were randomly divided into experimental group and control group; the experimental group were treated with improved surgical of small bone window,and the control group received traditional small bone flap surgery.The effects of the two groups and postoperative hematoma viability was compared.Results Among the 42 patients in experimental group,32 cases had thorough clearance,7 cases mostly clearance,and the total efficiency was 92.9％,3 cases died; Among the 40 patients in control group,21 cases had thorough clearance,12 cases mostly clearance,and the total effective rate was 82.5％,7 cases died.Differences in the two groups was statistically significant above index contrast （P ＜ 0.05）.The overall postoperative follow-up treatment effect in the experimental group was significantly better than that in the control group （P ＜ 0.05）.Conclusions Improved small bone window surgical treatment of hypertensive basal ganglia hemorrhage is effective,safe and reliable with fewer complications,so it can significantly improve the quality of life of patients and is worthy of research and promotion.