小骨窗显微血肿清除术后亚低温治疗高血压性脑出血疗效观察

Clinical Effect of Small-Skull-Window Microscopic Craniotomy Hematoma Removal with Mild Hypothermia in Hypertensive Intracerebral Hemorrhage

【目的】探讨高血压性脑出血患者行小骨窗显微血肿清除术后给予亚低温治疗的临床疗效。【方法】选择2010年1月至2015年1月本院神经外科收治的220例高血压性脑出血的患者，将手术后采用亚低温治疗者作为观察组（n：120）。将手术后接受常规治疗者作为对照组（n=100），比较两组患者手术后格拉斯哥评分情况、病死率及治疗的总有效率。【结果】观察组术后治疗的总有效率为90．84％（109／120），显著高于对照组的54．00％（54／100），差异具有统计学意义（x2=38．550，P〈0．001）；观察组病死率为2．50％（3／120）显著低于对照组的14．00％（14／100），差异具有统计学意义（x2=10．117，P=0．001）。观察组和对照组术后1、7d哥斯拉格评分比较差异均无统计学意义（均P〉0．05），而手术后14d观察组患者哥斯拉格评分显著高于对照组，差异具有统计学意义（P〈O．001）。【结论】小骨窗显微术后结合亚低温治疗高血压性脑出血的治疗效果优于小骨窗显微手术术后给予常规药物治疗的方法，值得在临床上推广应用。

[Objective]To explore the clinical curative effect of small-skull-window microscopic craniotomy hematoma removal with mild hypothermia in hypertensive intracerebral hemorrhage patients.[MethodslThe 220 patients with hypertensive cerebral hemorrhage were selected from the Department of neurosurgery in our hospital from January 2010 to January 2015, and the patients treated with mild hypothermia after surgery were set as observation group （ n = 120）, and those with normal therapy as control group （ n = 100）. The Glasgow scoring, the mortality rate and the total effective rate were compared between the two groups.[ResultslAfter treatment the total effective rate of the observation group was 90.84 ~//00 109/120, which was significantly higher than that of control group 54.00% （54/100）, the difference had statistical significance （x2= 38.550, P 〈 0.01） . In the observation group, the mortality rate 2.50% （3/120） was significantly lower than that of the control group 14.00 %（14/100）, the difference had statistical significance （x2 = 10.117, P 〈0. 001）. The Glasgow score （1 and 7 d after surgery） of the observation group and the control group showed no significant difference （ P 〈0.05）. However, the Glasgow scoring 14 d after the operation of patients in the observation group was significantly higher than that of the control group, the difference was statistically significant （ P 〈0.001）.[Conclusion]The treatment effect of small-skull-window microscopic craniotomy hematoma removal with mild hypothermia in hypertensive intracerebral hemorrhage is superior to that with routine drug method. It is worthy to be popularized in clinic.