高血压脑出血应用小骨窗显微开颅术与骨瓣开颅术治疗的效果对照研究

Comparative Research on Treatment Effect of Small Bone Window Microscopic Craniotomy and Craniotomy with Bone Flap for Hypertensive Cere-bral Hemorrhage

目的高血压脑出血应用小骨窗显微开颅术治疗的疗效。方法选取82例于2013年8月—2014年8月期间该院接收的高血压脑出血患者,将入选者随机分为对照组(给予小骨窗显微开颅术治疗,n=41)与观察组(给予骨瓣开颅术治疗,n=41),观察两组治疗效果。结果观察组的术中输血量、住院时间以及手术时间分别为(84.15±32.17)m L、(6.5±0.90)d、(2.1±0.60)h,观察组术中失血量、住院时间、手术时间均显著低于对照组(P<0.05);半年后观察组GOS评分结果为:4~5分31例,2~3分9例,1分1例,观察组中残及恢复良好率显著优于对照组(P<0.05);治疗前,两组GCS评分比较差异无统计学意义(P>0.05),术后1周,观察组GCS评分显著上升,上升至(13.91±1.62)分,显著优于对照组(P<0.05);观察组并发症发生率以及病死率分别为12.2%、2.4%,观察组术后病死率及并发症发生率低于对照组(P<0.05)。结论高血压脑出血采取小骨显微开颅术治疗可降低术后病死率,提高预后,且具有微创特点,具有推广价值。

Objective To re se a rch th e cu ra tive effect of small bone window mic ro scop ic craniotomy and craniotomy with bone flap for hyper tensive cerebral hemorrhage. Methods 82 c a se s of p a t ien ts with h yp er ten s iv e c e re b ra l hemorrhage adm i t-ted and treated in our hospi tal from August 2013 to August 2014 were selected and randomly divided into two groups with 41 cases in each, the control group were treated with small bone window microscopic craniotomy, while the observation group were treated with craniotomy with bone flap, and the treatment effect of the two groups was observed. Results T he in -traoperative transfus ion amount, length of stay and operat ive time in the observation group were respect ively（84.15±32.17）mL, （6.5±0.9）d, （2.1 ±0.6）h, and the intraoperative bleeding amount, length of stay and operat ive time in the observation group were obviously lower than those in the control group（P〈0.05）, and af ter half a yea, the GOS score resul t in the observation group, 4 to 5 scores was in 31 case, 2 to 3 scores was in 9 cases and 1 score was in 1 case, and the rehabi l i tat ion good rate in the observation group was obviously bet ter than that in the control group（P〈0.05）, before treatment, the difference in the GCS score between the two groups had no stat ist ical signi ficance（P〉0.05）, and at 1 week af ter operat ion, the GCS score in the observation group obviously increased to （13.91±1.62） scores, which was obviously bet ter than that in the control group, P〈0.05, and the incidence rate of complicat ions and morbidi ty rate in the observation group were respectively 12.2% and 2.4%, and the pos toperative morbidity rate and incidence rate of complications in the observation group were obviously low-er than those in the control group（P〈0.05）. Conclusion The small bone window mic ro scop ic craniotomy tre a tm en t for h y -per tens ive cerebral hemorrhage can reduce the pos toperative morbidi ty rate and improve the prognosis with the minimal in-vasive features , which is worth promotion.