高血压脑出血并发脑疝患者的手术方案研究

Study on surgical options for patients with hypertensive cerebral hemorrhage complicated with cerebral hernia

目的探讨高血压脑出血并发脑疝患者的手术方案。方法选取自2012年1月～2016年5月在我院接受治疗的高血压脑出血并发脑疝患者126例。根据不同的手术方式分为微创穿刺引流联合开颅血肿清除手术组（观察组）和单纯开颅血肿清除手术组（对照组），每组患者63例。术后6个月运用格拉斯哥评分（ glasgow outcome scale, GOS ）对两组患者进行生存状况评价，并运用健康促进生活方式量表（HPLP-Ⅱ）评分对患者生活质量进行测评。结果观察组患者的GOS预后评价明显优于对照组患者，生活质量评分明显高于对照组患者，差异具有统计学意义（P〈0．05）。结论微创穿刺引流联合开颅血肿清除术可以改善高血压脑出血并发脑疝患者的预后，提高患者术后生活质量，值得临床应用和推广。

Objective To investigate the surgical options for patients with hypertensive cerebral hemorrhage complicated with cerebral hernia. Methods 126 patients with hypertensive cerebral hemorrhage complicated with cerebral hernia were selected, who were in the hospital from January 2012 to May 2016. According to the different operation methods,the patients were divided into minimally invasive puncture drainage combined with eraniotomy hematoma removal surgery group （observation group） and simple craniotomy hematoma removal surgery group （control group）,63 cases of each group. After 6 months,glasgow outcome scale（GOS） was used to evaluate the survival status of patients in the two groups.The Health Promotion Lifestyle Scale （HPLP-） score was used to evaluate the quality of life. Results GOS evaluation of the observation group was significantly better than that of the control group,and the quality of life score of the observation group was significantly higher than that of the control group,the differences were statistically significant （P 〈 0.05）. Conclusion Minimally invasive puncture drainage combined with craniotomy can improve the prognosis of patients with hypertensive cerebral hemorrhage complicated with cerebral hernia,and improve the quality of life of patients.It is worthy of clinical application and promotion.