小骨瓣开颅显微手术治疗高血压性脑出血效果分析

Effect of small craniotomy microsurgery treatment on hypertensive cerebral hemorrhage

目的 探究小骨瓣开颅显微手术治疗高血压性脑出血效果。方法 选择156例原发性高血压脑出血患者，随机分为对照组与观察组。对照组予以传统大骨瓣开颅手术，观察组予以小骨瓣开颅显微手术。观察比较两组血肿清除率、血肿复发率、病死率、术后并发症率、功能恢复情况等指标。结果 两组血肿清除率、血肿复发率、病死率比较差异未见统计学意义（P〉0.05）。观察组术后并发症率为12.8%，低于对照组的34.6%（P〈0.05）。随访6～12个月，观察组ADL预后良好率为84.6%，高于对照组的64.1%（P〈0.05）。结论 骨窗开颅显微手术在高血压性脑出血治疗中可取得与传统大骨瓣开颅手术相似的近期临床疗效，且可进一步降低术后并发症，改善远期生活质量。

Objective To investigate the effect of small craniotomy microsurgery treatment on hypertensive cerebral hemorrhage.Methods A total of 156 patients with essential hypertensive intracerebral hemorrhage were selected and divided into the control group and observation group randomly. The control group was treated by the traditional big bone flap craniotomy treatment, and the observation group was treated by small craniotomy microsurgery treatment. The clearance rate of hematoma, hematoma recurrence rate, mortality, postoperative complication rate and functional recovery were compared between the two groups.Results There was no significant difference between the two groups in hematoma clearance rate, recurrence rate or mortality （P〉0.05）. The postoperative complication rate of the observation group was 12.8%, which was significantly lower than that of the control group （P〈0.05）. After the follow-up of 6-12 months, the prognosis of activities of daily living in the observation group was 84.6%, which was significantly higher than that of the control group （P〈0.05）.Conclusions Small craniotomy microsurgical treatment can achieve similar clinical efficacy as compared with conventional craniotomy in the treatment of hypertensive cerebral hemorrhage, and reduce postoperative complication further and improve the long-term quality of life.