小骨窗开颅与硬通道穿刺治疗高血压脑出血的临床疗效及安全性分析

Clinical efficacy and safety of small bone window craniotomy and hard channel puncture in treatment of hypertensive intracerebral hemorrhage

目的探究小骨窗开颅与硬通道穿刺治疗高血压脑出血的临床疗效及安全性。方法前瞻性选取2013年3月至2016年8月本院与协助单位广东三九脑科医院收治的76例高血压脑出血患者临床资料,按照治疗方式的不同分为对照组(38例)和研究组(38例),对照组行硬通道穿刺术,研究组行小骨窗开颅术,观察两组颅内血肿量、NIHSS评分以及并发症发生率。结果研究组术后1 d、3 d和7 d颅内血肿量均显著低于对照组(P<0.05),研究组术后1周、2周和4周NIHSS评分较对照组显著低(P<0.05),研究组并发症总发生率比对照组低(P<0.05)。结论与硬通道穿刺治疗方式相比,小骨窗开颅术治疗高血压脑出血能够显著降低血肿量,提高神经功能恢复情况,并发症发生率低,具临床推广和应用价值。

Objective To explore the clinical efficacy and safety of small bone window craniotomy and hard channel puncture in the treatment of hypertensive intracerebral hemorrhage.Methods 76 patients with hypertensive intracerebral hemorrhage admitted in our hospital and Guangdong Sanjiu Brain Hospitalfrom March,2013 to August,2016 were divided into control group（38 cases） according to the different treatment methods.And the study group（38 cases）.The control group underwent hard channel puncture.The study group was treated with small bone window craniotomy.The intracranial hematoma volume,NIHSS score and complication rate were observed.Results The intracranial hematomas in the study group were significantly lower than those in the control group at 1d,3d and 7d（P〈0.05）.The NIHSS scores of the study group were significantly lower than those of the control group at 1 week,2 weeks and 4 weeks）.The total complication rate in the study group was lower than that in the control group（P〈0.05）.Conclusions Small bone window craniotomy can significantly reduce hematoma volume and improve the recovery of neurological function,and the occurrence rate is low.It is of clinical application and value in the treatment of hypertensive intracerebral hemorrhage compared with hard channel puncture.