常规骨瓣开颅脑血肿清除术与小骨窗脑血肿清除术治疗高血压脑出血的临床对比研究

Control study of routine removal of bone flap open cerebral hematoma and small bone window for brain hematoma removal in the treatment of hypertensive intracerebral hemorrhage

目的 探究与分析常规骨瓣开颅脑血肿清除术与小骨窗脑血肿清除术治疗高血压脑出血的临床治疗效果.方法 选取我院神经外科2013年1月至2014年12月收治的90例脑血肿患者作为研究对象,选取随机数表法分为以小骨窗脑血肿清除术治疗的实验组和以常规骨瓣开颅脑血肿清除术治疗的对照组,每组45例.对比两组患者临床疗效、手术时间、并发症发生率、住院时间、血肿清除率.结果 实验组总有效率93.33％,对照组总有效率66.67％,组间相比差异有统计学意义（x^2=4.21,P＜0.05）.实验组手术时间、血肿清除率、住院时间分别为（1.88±0.41）h、（82.29±14.22）％、（12.15±5.65）d,对照组分别为（2.24±0.55）h、（61.25±13.25）％、（20.45±8.43）d;实验组和对照组并发症发生率分别为11.11％、37.78％,差异有统计学意义（P＜0.05）.结论 小骨窗脑血肿清除术治疗高血压脑出血的临床疗效突出,相比于常规骨瓣开颅脑血肿清除术具有诸多优势,可作为一种理想方法应用于临床工作中.

Objective To explore clinical efficacy of routine removal of bone flap open cerebral hematoma and small bone window for brain hematoma removal in the treatment of hypertensive intracerebral hemorrhage （HICH）.Methods 90 patients with cerebral hematoma in department of neurosurgery of our hospital from January 2013 to December 2014 were selected as the research object,divided into experimental group （small bone window for brain hematoma removal） and control group （routine removal of bone flap open cerebral hematoma） according to random number table method,45 cases in each group.Compared clinical curative effect,operation time,complication rate,length of hospital stay,hematoma clearance rate of two groups.Results The total effective rate was 93.33% in experimental group and 66.67% in control group respectively,with statistically significant difference between two groups （x^2=4.21,P〈0.05）.Operation time,hematoma clearance rate,length of hospital stay were （1.88±0.41）h,（82.29±14.22）%,（12.15±5.65） d in experimental group and （2.24±0.55）h,（61.25±13.25）%,（20.45±8.43）d in control group respectively.The complication rate was 11.11% in experimental group and 37.78% in control group,with statistically significant difference between two groups （P〈0.05）.Conclusion Small bone window for brain hematoma removal in the treatment of HICH has significant curative effect,has many advantages compared with routine removal of bone flap open cerebral hematoma,can be used as an ideal method in clinical work.