早期开颅清除脑内血肿并去骨瓣减压术治疗重症脑出血的疗效分析

Analysis of Curative Effect of Early Craniotomy on Removal of Intracranial Hematoma and Decompressive Craniectomy for Severe Intracerebral Hemorrhage

目的研究早期手术开颅清除脑内血肿并去骨瓣减压治疗重症脑出血的临床疗效。方法选取我院2014年1月—2016年12月的收治的重症脑出血患者63例作为研究对象。采取开颅清除脑内血肿并去骨瓣减压术,并对术后3个月的病死率与疗效进行分析。结果术后24小时行头颅CT复查,血肿清除率50%~95%,平均(79.3±3.2)%。术后3个月死亡14例,病死率22.2%,并发症发生率77.8%;术后3个月进行疗效评定,采用日常生活能力评估(ADL),预后良好38例,预后不良25例,总有效率60.3%。结论早期手术开颅清除脑内血肿并去骨瓣减压治疗重症脑出血,可以降低颅内压,减轻神经损害,促进神经功能恢复,可以降低病死率,是治疗重症脑出血的有效方案。

Objective To study the clinical effect of early craniotomy to remove intracranial hematoma and decompressive craniectomy in the treatment of severe cerebral hemorrhage. Methods 63 patients with severe cerebral hemorrhage admitted in our hospital from January 2014 to December 2016 were selected as the study subjects. Craniotomy was performed to remove the hematoma and decompressive craniectomy, and the mortality and efficacy of the 3 months after operation were analyzed. Results CT examinations were performed at 24 hours after operation, and the hematoma clearance rate ranged from 50% to 95%, with an.average of （79.3：t：3.2）%. 3 months after operation, 14 cases died, the fatality rate was 22.2%, and the complication rate was 77.8%. The curative effect was evaluated 3 months after operation, and the daily living ability assessment （ADL） was performed. The prognosis was good in 38 cases, and the prognosis was poor in 25 cases. The total effective rate was 60.3%. Conclusion Early craniotomy to remove intracranial hematoma and decompressive craniectomy for severe intracerebral hemorrhage, it can reduce intracranial pressure, relieve nerve damage, promote the recovery of neurological function and reduce the fatality rate. It is an effective treatment for severe intracerebral hemorrhage.