去骨瓣减压术在高血压脑出血手术治疗中的应用价值分析

Analysis on the application value of decompression with bone flap in the treatment of hypertensive cerebral hemorrhage

目的:探讨去骨瓣减压术在高血压脑出血手术治疗中的应用价值分析。方法:将2014年6月—2017年6月在我院神经外科手术治疗的86例高血压脑出血患者随机分为两组,对照组单纯行开颅血肿清除术,观察组行开颅血肿清除术联合去骨瓣减压术,比较两组患者的手术疗效、血肿清除率和脑出血再发率、神经功能及生活质量改善情况。结果:观察组预后良好率88.37%,明显高于对照组的69.77%,差异有统计学意义(P<0.05);观察组术后血肿清除率明显低于对照组(P<0.05),脑出血再发率与对照组相比无明显差异(P>0.05);观察组术后1个月、3个月NIHSS评分、BI指数与对照组相比明显改善,差异有统计学意义(P<0.05)。结论:去骨瓣减压术在高血压脑出血手术治疗中的应用效果显著,能够提高手术疗效,防止脑出血后继发性脑损伤,改善预后,促进神经功能的恢复,具有积极临床意义。

Objective:To explore the application value of decompression with bone flap in the treatment of hypertensive cerebral hemorrhage.Methods:86 patients with hypertensive cerebral hemorrhage who received neurosurgery of surgical treatment in our hospital from June 2014 to June 2017 were randomly divided into two groups,the control group received pure line removal of hematoma,the observation group received line removal of hematoma combined with bone flap craniotomy decompression,the operative efficacy,the clearance of hematoma and cerebral hemorrhage recurrence rate,neural function and improvement of the quality of life of two groups of patients were compared.Results:The good prognosis rate of the observation group was 88.37%,which was significantly higher than that of the control group,69.77%,and the difference was statistically significant(P<0.05).The postoperative hematoma clearance rate of the observation group was significantly lower than that of the control group(P<0.05),and the recurrence rate of cerebral hemorrhage was not significantly different from that of the control group(P>0.05).Compared with the control group,the NIHSS score and BI index of the observation group were significantly improved 1 month and 3 months after surgery,and the difference was statistically significant(P<0.05).Conclusion:The application of bone flap decompression in the treatment of hypertensive intracerebral hemorrhage had a positive clinical significance.It could improve the curative effect,prevent the secondary brain injury,improve the prognosis and promote the recovery of nerve function after intracerebral hemorrhage.