高血压脑出血治疗中应用超早期小骨窗微创颅内血肿清除术的疗效分析

Curative Effect of Ultra-early Small Bone Window Minimally Invasive Clear Intracranial Hematoma in Treating Hypertensive Intracerebral Hemorrhage

目的:观察超早期小骨窗微创颅内血肿清除术对于高血压脑出血的临床治疗效果。方法:选取高血压脑出血患者103例,随机分为两组,观察组54例采用小骨窗微创血肿清除术治疗,对照组49例采用传统开颅手术治疗,对比分析两组的治疗效果。结果:观察组的总有效率为88.9%,与对照组(71.4%)相比差异具有统计学意义(P<0.05);观察组的手术时间为(33.4±10.8)min,低于对照组患者(81.5±34.2)min(P<0.05);两组患者的血肿清除率分别为(94.3±5.2)%和(87.7±6.5)%,观察组高于对照组(P<0.05);两组患者的血肿吸收时间分别为(5.4±1.3)d和(6.9±1.2)d,住院时间分别为(17.9±6.9)d和(23.3±7.2)d,观察组短于对照组(P<0.05)。术后,两组患者的神经功能缺损较手术前均有了改善,观察组患者的神经功能缺损评分低于对照组(P<0.05);观察组患者的并发症发生率低于对照组(P<0.05),两组死亡率不存在统计学差异(P>0.05)。结论:超早期小骨窗微创血肿清除术治疗高血压脑出血效果良好,有效率高,手术后患者神经功能恢复较好,并发症发生率低,安全性高,值得临床推广。

Objective： To observe the clinic effect of ultra-early small bone window minimally invasive clear intracranial hematoma in treating Hypertensive intracerebral hemorrhage. Methods： 103 patients with hypertensive cerebral hemorrhage were randomly divided into two groups,the observation group（ n = 54） were treated by small bone window minimally invasive clear intracranial hematoma,and the control group（ n = 49）were treated with traditional craniotomy,clinical curative effect of the 2 groups were compared after surgery.Results： The total effective rate of observation group was 88. 9%,significantly different compared with the control group（ 71.4%）（ P 〈0.05）; The operation time of the observation group were（ 33.4±10.8） min,significantly lower than the control group（ 81.5 ± 34.2） min（ P 〈 0. 05）; The hematoma clearance rate of two groups respectively（ 94.3±5.2） % and（ 87.7 ± 6.5） %,the observation group was significantly higher than the control group（ P 〈 0.05）; The hematoma absorption time were（ 5.4±1.3） d and d（ 6.9±1.2） d,the hospitalization days were（ 17. 9 ± 6. 9） d and（ 23. 3 ± 7. 2） d drespectively,observation group was significantly shorter than the control group（ P 〈 0.05）; After surgery,neurologic impairment of all patients were improved significantly,but the neurologic impairment score of observation group was significantly lower than control group（ P〈 0.05）; The complication incidence rate of observation group was significantly lower than the control group（ P 〈 0.05）,there was no statistically significant difference between the two groups in mortality（ P 〉 0.05）.Conclusions： Ultra-early small bone window minimally invasive clear intracranial hematoma had good effect and high efficiency to hypertensive intracerebral hemorrhage,patient had good neural functional recovery after surgery,and it also had low complication rate and high security,is worth clinical promotion.