不同术式治疗高血压脑出血的疗效对比研究

Study on the Comparison of Different Operation Methods in the Treatment of Patients with Hypertensive Cerebral Hemorrhage

目的:为了探究临床不同手术治疗方式对于高血压脑出血的临床实际治疗效果,从而为高血压脑出血的相关研究和临床实践提供依据和参考。方法:本次研究所选取的对象均为我院2009年1月-2012年1月期间收治的高血压脑出血患者,共计72例。根据所采用的手术方法不同,对患者进行分组,分成骨瓣开颅组和钻孔引流组。观察并比较两组研究对象实施不同手术治疗方法后1周内恢复意识情况、2周内发生并发症情况以及手术24h后GCS评分和手术1个月后FAM评分结果。结果:(1)在1周内意识恢复效果上组间比较,钻孔引流组的意识恢复效果明显优于骨瓣开颅组,且差异具有显著的统计学意义(χ2=4.599 7,P=0.032 0);在2周内并发症发生情况上组间比较,钻孔引流组患者的并发症发生情况明显少于骨瓣开颅组,且差异具有显著的统计学意义(χ2=4.963 4,P=0.025 9);(2)在患者实施手术治疗24h后的GCS评分结果上,组间比较,钻孔引流组患者的GCS评分结果明显优于骨瓣开颅组,且差异具有显著的统计学意义(t=2.154 3,P=0.034 7);在患者实施手术治疗1个月后的FAM评分结果上,组间比较,钻孔引流组患者的FAM评分结果明显优于骨瓣开颅组,且差异具有显著的统计学意义(t=6.136,P=0.0000)。结论:在临床针对高血压脑出血患者实施治疗的实践过程中,采用钻孔引流手术方式的临床效果显著,是临床针对高血压脑出血患者实施治疗的可靠选择。

Objective：To study the clinical treatment effect of different operation methods in the treatment of patients with hypertensive cerebral hemorrhage,in order to provide evidence and consulting for the related study and clinical practice of hypertensive cerebral hemorrhage.Methods：72of patients with hypertensive cerebral hemorrhage in our hospital from January 2009 to January 2012 were selected as research object,and the patients were divided into bone flap craniotomy group and trepanation and drainage group according to the differences of operation methods,then the recovery situation of consciousness at first week,complication rate at second week,GCS score at 24 hand FAM score at 1month after the operation of two groups were observed and compared.Results：（1）The recovery effect of consciousness of trepanation and drainage group at first week was obviously better than that of bone flap craniotomy group,there was significant difference（χ^2=4.599 7,P=0.032 0）;the complication rate of consciousness of trepanation and drainage group at second week was obviously lower than that of bone flap craniotomy group,there was significant difference（χ^2=4.963 4,P=0.025 9）;（2）the GCS score of trepanation and drainage group at 24 hafter the operation was obviously better than that of bone flap craniotomy group,there was significant difference（t=2.154 3,P=0.034 7）;the FAM score of trepanation and drainage group at 1month after the operation was obviously better than that of bone flap craniotomy group,there was significant difference（t=6.136,P=0.0000）.Conclusion：The clinical effect of trepanation and drainage is significant during the treatment period of hypertensive cerebral hemorrhage,and it is the reliable choice for the treatment of hypertensive cerebral hemorrhage.