微骨窗血肿清除术在特定出血量高血压脑出血治疗中的应用

Application of Intracerebral Hematoma Evacuation by Microsurgery with Micro-bone Window Craniotomy to the Patients with Specified Intracere-bral Hematoma Volume

目的分析30-45 m L出血量的高血压脑出血患者保守治疗和手术治疗的临床资料,探讨微骨窗开颅显微血肿清除术在此类患者中的应用。方法方便收集该院2012年1月—2015年9月确诊的30-45 m L高血压脑出血患者59例,根据不同治疗方法分为两组,行微骨窗开颅显微手术清除血肿35例（微创组）,行药物保守治疗24例（保守组）,回顾性总结分析两组在住院天数、肺炎发生率、6月GOS评分、甘露醇使用情况等方面的差异。结果微创组住院天数（19.06±4.20）d明显少于保守组（28.78±6.57）d;微创组肺炎发生率25.7%明显小于保守组54.2%;微创组甘露醇使用次数（44.89±4.70）次明显少于保守组（61.79±7.49）次;微创组脱水药联合使用情况20%明显少于保守组62.5%。结论微骨窗开颅显微血肿清除术在30-45 m L出血量的高血压脑出血患者中值得推广应用。

Objective To analyze the clinical data of conservative treatment and surgical treatment to hypertensive intracerebral hemorrhage in patients with 30-45 m L hematoma volume, and explore the application of intracerebral hematoma evacuation by microsurgery with micro-bone window craniotomy. Methods Convenient selection 59 cases of hypertensive intracerebral hemorrhage with 30~45 m L hematoma volume were collected from January 2012 to September 2015 in our hospital. Intracerebral hematoma evacuation by microsurgery with micro-bone window craniotomy was applicated to 35 patients（minimally invasive group）.Drug therapy was applicated to 24 patients（conservative groups）.A retrospective analysis of hospital days、incidence rate of pneumonia and the usage of mannitol to the two groups were expanded. Results Hospital days in minimally invasibe group（19.06±4.20）d was less than the conservative group（28.78±6.57）d; The incidence rate of pneumonia in minimally invasibe group 26.7% was less than the conservative group54.2%; The usage of mannitol in minimally invasibe group（44.89±4.70）times was less than the conservative group（61.79±7.49）times; The types of dehydration drugs in minimally invasibe group 20% were less than the conservative group 62.5%. Conclusion Intracerebral hematoma evacuation by microsurgery with micro-bone window craniotomy to the patients with 30~45 m L intracerebral hematoma volume is worth to applicate.