三种不同术式治疗高血压性脑出血临床疗效探讨

Clinical Efficacy of Three Different Surgical Methods for Hypertensive Intracerebral Hemorrhage

目的探讨三种不同术式治疗高血压性脑出血的临床疗效。方法选择于2015年6月—2016年6月我院收治的96例高血压性脑出血患者作为研究对象,随机分为A、B、C三组,每组32例患者。A组采用大骨瓣开颅术、B组采用小骨窗血肿清除术、C组采用微创血肿清除术进行治疗,观察对比三组患者的临床疗效、手术情况、GCS评分以及ADL评分。结果 C组患者的术后GOS预后评估,术后6个月的ADL预后评分,手术时间,术中出血量等手术情况,优于A组和B组。C组的死亡率低于A组和B组,差异有统计学意义(P<0.05)。三组患者在出、入院时GCS评分差异均无统计学意义。但是,三组患者在出院后,与出院前,均都得到改善(P<0.05)。结论微创血肿清除术组的临床疗效优于大骨瓣开颅术组和小骨窗血肿清除术,并且有良好的预后。

Objective To investigate the clinical efcacy of three diferent surgical treatment of hypertensive intracerebral hemorrhage. Methods From June 2015 to June 2016, 96 patients with hypertensive intracerebral hemorrhage admitted in our hospital were selected as the research objects and randomly divided into three groups, A, B and C, with 32 patients in each group. Group A was treated with large bone fap craniotomy, group B with small bone window hematoma removal, and group C with minimally invasive hematoma removal, clinical efficacy, operation, GCS score and ADL score were observed and compared between the three groups. Results The prognosis of GOS, the ADL prognosis score, the operation time and the amount of blood loss during the 6 months after the operation were better than those of the large craniotomy group and the small bone window hematoma removal. The mortality of the A group was lower than that of the B group and the C group, the diference was statistically signifcant （P 〈 0.05）. There was no signifcant diference in GCS scores between the three groups at admission and admission. However, the three groups were improved after discharge and before discharge （P 〈 0.05）. Conclusion The clinical efficacy of minimally invasive hematoma removal group was signifcantly better than that of large craniotomy craniotomy group and small bone window hematoma removal surgery, and had a good prognosis.