直切口小骨窗开颅清除术治疗硬脑膜外血肿疗效观察

Curative Effect of Straight Incision and Small Bone Window Craniotomy Debridement for Treatment of Epidural Hematoma

[目的]探讨直切口小骨窗开颅清除术治疗硬脑膜外血肿的临床疗效。[方法]选择本院收治的114例硬脑膜外血肿患者的临床资料，根据手术方法分为观察组和对照组，其中观察组59例行直切口小骨窗开颅清除术治疗，对照组55例行常规皮瓣开颅术治疗，比较两组患者的围术期指标的差异；比较两组患者治疗前后意识、肢体活动、语言、GCS评分的差异。比较两组患者治疗后G0s评分的差异。[结果]观察组的手术时间、术中出血量、输血量、心率（HR）、呼吸频率均低于对照组，观察组的血氧饱和度高于对照组，差异均具有统计学意义（均P〈0．05）；观察组的平均动脉压与对照组比较，差异无统计学意义（P〉0．05）。两组患者治疗后的意识、肢体活动、语言、GCS评分均高于治疗前，且差异有统计学意义（均P〈0．05）；观察组在治疗后的意识、肢体活动、语言、GCS评分均高于对照组，差异均有统计学意义（均P〈0．05）。两组患者治疗后GOS评分疗效的差异无统计学意义（P〉0．05）。[结论]直切口小骨窗开颅清除术能够有效清除血肿、降低颅内压，对患者意识及神经功能改善优于常规骨瓣开颅术。

[Objective]To investigate the curative effect of straight incision and small bone window craniotomy debridement for treatment of epidural hematoma.[Methods]One hundred and fourteen cases of epidural hematoma in our hospital were selected and divided into the observation group and the control group according to the operation method , the observation group of 59 cases were treated with straight incision and small bone window craniotomy debridement, the control group of 55 cases were treated with routine flap craniotomy, the differences of perioperative indicators between the two groups were compared; the differences of awareness, physical activity, language, GCS score before and after the treatment between the two groups were compared; The differences of GOS score after treatment in two groups were compared.[Results]The operation time, blood loss, blood transfusion, heart rate （HR） and respiratory rate in the observation group were lower than those in the control group, the blood oxygen saturation in the observation group was higher than that in the control group, the difference was statistically significant （mean P 〈0.05） ; Compared with the control group, the difference of the mean arterial pressure in the observation group was not statistically significant （ P 〉0.05）. Consciousness, physical activity, language, GCS scores of the two groups of patients after ti＇eatment were higher than those before treatment, and the difference was statistically significant （ P 〈0.05）; consciousness, physical activity, language, GCS scores of the observation group after the treatment were higher than those in the control group, the difference was statistically significant （both P 〈0.05）. After treatment, there was no significant difference in the efficacy of GOS score between the two groups （ P 〉0.05）.[Conclusion]Straight incision and small bone window craniotomy debridement can effectively remove the hematoma and reduce the intracranial pressure, which is superior to the conventional bone flap craniotomy in the improvement of the consciousness of the patients and the improvement of the nerve function.