大骨瓣减压及小骨窗开颅骨瓣复位治疗高血压性幕上脑出血的疗效比较

Clinical efficacy of two kinds of surgical treatment for hypertensive supratentorial intracerebral hemorrhage by comparison of large bone flap decompression and reduction of small bone window craniotomy

目的研究高血压性幕上脑出血患者行大骨瓣减压及小骨窗开颅骨瓣复位治疗的临床效果。方法选择2014年10月—2017年10月我院高血压性幕上脑出血患者100例,依据手术术式分为2组,观察组接受大骨瓣减压治疗,对照组接受小骨窗开颅骨瓣复位治疗,比较2组治疗效果。结果观察组治疗后1周GCS评分为(13.69±2.02)分,对照组(10.85±1.87)分;观察组术后1周治疗有效率为78%,对照组为58%;观察组术后3个月ADL评分为(79.58±6.69)分,对照组(64.48±6.28)分;观察组术后并发症发生率为10%,低于对照组的34%,差异均有统计学意义(P<0.05)。结论大骨瓣减压术式治疗高血压性幕上脑出血的临床效果要优于小骨窗开颅骨瓣复位,尤其适用于重症脑出血患者,更有推广价值。

Objective To study the hypertensive supratentorial intracerebral hemorrhage patients received different clinical effect of big bone flap decompression and craniotomy with bone flap treatment. Methods Select 100 cases of hypertensive supratentorial intracerebral hemorrhage in our hospital from October 2014 to October 2017,and divided into 2 groups according to the procedure formula.The observation group received large bone flap decompression treatment,and the control group received small bone window open skull flap reduction treatment,and compared the two groups of operation effects. Results The GCS score was 13.69±2.02 in the observation group and 10.85 ±1.87 in the control group one week after treatment. The effective rate of treatment was 78 in the observation group and 58 in the control group one week after operation.The ADL score was 79.58 ±6.69 in the observation group and 64.48 ±6.28 in the control group 3 months after operation.The incidence of postoperative complications in the observation group was 10,lower than that in the control group. Conclusion The clinical effect of big bone flap decompression for the treatment of hypertensive supratentorial intracerebral hemorrhage better than craniotomy with bone flap replacement,big bone flap decompression type is especially suitable for the treatment of patients with severe cerebral hemorrhage,more popularization value.