小骨窗微创手术治疗高血压脑出血患者的疗效

The Curative Efficacy of Small Bone Window of Minimally Invasive Surgery in Patients with Hypertensive Cerebral Hemorrhage

目的:分析小骨窗微创手术在高血压脑出血患者的临床效果。方法:选取我院收治的高血压脑出血患者200例,按照治疗方式的不同分为观察组100例,对照组100例,观察组采用小骨窗微创手术治疗,对照组采用传统开颅手术治疗,对两组疗效及预后进行对比。结果:两组患者的术后残留血肿量较术前明显减少,差异有统计学意义(P<0.05),观察组术后残留血肿量(10.3±2.8)m L,对照组术后残留血肿量(11.1±3.0)m L,两组之间术后血肿残留量比较,差异无统计学意义(P>0.05)。观察组手术时间(92.8±15.5)分钟,对照组手术时间(125.4±16.1)分钟,观察组手术时间明显短于对照组,差异有统计学意义(P<0.05)。观察组住院时间(15.8±5.2)天,对照组住院时间(24.1±5.8)天,观察组住院时间明显短于对照组,差异有统计学意义(P<0.05)。再出血率比较:观察组治疗后再出血率3.0%,对照组治疗后再出血率8.0%,观察组出血率明显低于对照组,差异有统计学意义(P<0.05)。NDS及ADL比较:两组治疗后NDS及ADL均优于治疗前,差异有统计学意义(P<0.05)。观察组NDS及ADL均显著优于对照组,差异有统计学意义(P<0.05)。GCS比较:两组评分差异无统计学意义(P>0.05)。结论:小骨窗微创手术可以改善患者的预后,可显著提高高血压脑出血治疗效果。

Objective： To study the clinical curative effect of small bone window of minimally invasive surgery for cerebral hemorrhage. Methods： 200 cases of hypertensive cerebral hemorrhage patients were selected in our hospital and divided into the observation group and the control group with 100 cases in each group according to the treatment modalities. The patients in observation group were treated with small bone window of minimally invasive surgery, and the patients in control group were received traditional craniotomy operation. The curative efficacy and prognosis were compared. Results： After treatment, the residual hematoma volume in both two groups were obviously decreased with statistical significance compared with before operation （P〈0.05）, and the postoperative residual hematoma volume was （10.3± 2.8） mL in observation group, and （11.1± 3.0） mL in control group, and the difference was not statistically significant between two groups （P〉0.05）. The operation time was （92.8 ± 15.5） rain in observation group, and （125.4 ＋ 16.1） min in control group, the operation time was significantly shorter in observation group than that of the control group, and the difference was statistically significant （P 〈0.05）. The length of stay was （15.8± 5.2） d in observation group, and （24.1± 5.8） d in control group, and the difference was statistically significant between two groups （P〈0.05）. The rebleeding rate was 3 % in observation group and 8 % in control group, the rebleeding rate in the observation group was significantly lower than that in the control group with statistical significance （P〈0.05）. The ADL and NDS of two groups after treatment were better than before treatment, the difference was statistically significant （P〈0.05）, and it was significantly better in observation group than that of the control group, the difference was statistically significant （P〈0.05）. The difference of GCS between the two groups was not statistically significant （P〉0.05）. Conclusions： Small bone window of minimally invasive surgery can significantly improve the curative efficacy and prognosis in the treatment of hypertensive cerebral hemorrhage.