不同出血量采用小骨窗开颅与常规骨瓣开颅治疗高血压脑出血临床对比研究

Clinical comparative study of small bone flap craniotomy and conventional bone flap craniotomy in the treatment of hypertensive cerebral hemorrhage with different amount of bleeding

目的：探讨不同出血量采用小骨窗开颅与常规骨瓣开颅治疗高血压脑出血的临床效果。方法：收治高血压脑出血患者96 例，分为A 组(小骨窗开颅术)及B 组(常规骨瓣开颅术)，比较两组的治疗效果。结果：A 组手术时间、术中输血量及住院时间明显优于B 组(P＜0.05)，A 组发生切口脑脊液漏的概率明显低于B 组(P＜0.05)。当出血量在30～60 mL 时，两组治疗总有效率分别为83.33%及83.33%，治疗效果基本相同(P＞0.05)，当出血量为60～80 mL 时，两组治疗总有效率分别为60.00%及79.17%，A 组治疗效果明显低于B 组(P＜0.05)。结论：对高血压脑出血患者进行治疗，应根据患者具体病情选择合适的治疗方法，对出血量较多的患者采用常规骨瓣开颅治疗，以提高治疗效果；对出血量较少的患者采用小骨窗开颅治疗，在保证治疗效果基本不变的情况下，减少患者并发症及治疗时间。

Objective:To explore the clinical effect of small bone flap craniotomy and conventional bone flap craniotomy in thetreatment of hypertensive cerebral hemorrhage with different amount of bleeding.Methods:96 patients with hypertensive cerebralhemorrhage were selected.They were divided into the A group(small bone flap craniotomy) and the B group(conventional bone flapcraniotomy),and we compared the treatment effect of two groups.Results:In the A group,operation time,intraoperative bloodtransfusion volume and hospital stay were significantly better than the B group(P<0.05).In the A group,the probability of CSFleakage was significantly lower than the B group(P<0.05).When the amount of bleeding was 30 to 60 mL,the total effective rate ofthe two groups was 83.33% and 83.33% respectively,and the treatment effect was basically the same(P>0.05).When the amountof bleeding was 60 to 80 mL,the total effective rate of the two groups was 60% and 79.17% respectively,and the effect of A groupwas significantly lower than that of B group(P<0.05).Conclusion:In the treatment of hypertensive cerebral hemorrhage patients,weshould choose the appropriate treatment according to the specific condition of the patient.For patients with high blood loss,we canuse conventional bone flap craniotomy,in order to improve the treatment effect.For patients with a lower amount of hemorrhage,weshould choose small bone flap craniotomy,on the basis of ensuring the treatment effect,which can reduce the complications andtreatment time.