锥颅置管颅内血肿清除术与传统大骨瓣开颅治疗高血压脑出血的疗效对比

COMPARISON OF CURATIVE EFFECT BETWEEN INTRACRANIAL HEMATOMA EVACUATION THROUGH DRILLING SKULL SET-IN TUBE AND TRADITIONAL LARGE TRAUMA CRANIOTOMY FOR HYPERTENSIVE CEREBRAL HEMORRHAGE

目的探究锥颅置管颅内血肿清除术与传统大骨瓣开颅治疗高血压脑出血的临床疗效。方法回顾性分析2016年1月-2017年3月于我院就诊的117例高血压脑出血患者的临床资料,依据手术方式不同分为锥颅置管组(65例)和大骨瓣开颅组(52例)。比较二组患者手术和住院时间、术后并发症发生情况。对比二组患者术后6个月和12个月病死率及术后6个月近期预后情况。结果锥颅置管组手术和住院时间均明显短于大骨瓣开颅组(P<0.05),且术后并发症发生率明显低于大骨瓣开颅组(P<0.05)。术后12个月,锥颅置管组病死率明显低于大骨瓣开颅组(P<0.05),且术后6个月,锥颅置管组近期预后优良率明显高于大骨瓣开颅组(P<0.05)。结论相比于传统大骨瓣开颅术,锥颅置管颅内血肿清除术治疗高血压脑出血效果更佳,能明显降低患者术后并发症发生率,提高患者近期预后。

Objective To investigate the clinical curative effect of intracranial hematoma evacuation through drilling skull set-in tube and traditional large trauma craniotomy for hypertensive cerebral hemorrhage.Methods The clinical data of one hundred and seventeen patients with hypertensive intracerebral hemorrhage treated in Suining Municipal Hospital of TCM from January 2016 to March 2017 were retrospectively analyzed.They were divided into two groups according to the amount of bleeding,location and operation conical catheterization group(n=65)and craniotomy group(n=52).The complications were compared between the two groups.Results The surgical time and length of hospital stay of the drilling skull set-in tube group were significantly shorter than those of the large trauma craniotomy group(P<0.05),and the incidence of postoperative complications was significantly lower than that in the large trauma craniotomy group(P<0.05).The mortality rates of the drilling skull set-in tube group in 12 months after surgery was significantly lower than those of the large trauma craniotomy group(P<0.05).The excellent and good rate of prognosis of the drilling skull set-in tube group at 6 months after surgery was significantly higher than that of the large trauma craniotomy group(P<0.05).Conclusion Compared with traditional large trauma craniotomy,the effect of intracranial hematoma evacuation through drilling skull set-in tube is better in treating hypertensive cerebral hemorrhage.It can significantly decrease the incidence of postoperative complications and improve the short-term prognosis of patients.