小骨窗颅内血肿清除术治疗高血压性脑出血的临床评价

Clinical evaluation of small bone window intracranial hematoma removal for hypertensive cerebral hemorrhage

目的评价高血压性脑出血患者应用小骨窗颅内血肿清除术治疗的临床效果。方法40例高血压性脑出血患者,根据随机双盲法分为对照组和观察组,每组20例。对照组患者给予大骨瓣开颅血肿清除术治疗,观察组患者给予小骨窗颅内血肿清除术治疗,比较两组围术期相关性指标(血肿清除情况、住院天数、手术时间)、临床疗效、简明健康状况调查表(SF-36)评分以及术后并发症发生情况。结果观察组患者的住院天数(20.40±4.15)d和手术时间(60.90±12.50)min均短于对照组的(30.50±6.50)d、(183.20±26.88)min,差异具有统计学意义(P<0.05)。观察组治疗总有效率为60.00%高于对照组的25.00%,差异具有统计学意义(P<0.05)。治疗后,两组活力、社会功能、精神健康、情感职能、生理功能、总体健康、躯体疼痛、生理职能评分均有所提高,且观察组患者的活力、社会功能、精神健康、情感职能、生理功能、总体健康、躯体疼痛、生理职能评分均高于对照组,差异具有统计学意义(P<0.05)。观察组总并发症发生率为20.00%低于对照组的55.00%,差异具有统计学意义(P<0.05)。结论针对高血压性脑出血患者,给予小骨窗颅内血肿清除术治疗具有显著的治疗效果,可大大提高患者的生活质量,在临床中的应用价值较高。

Objective To evaluate the clinical effect of small bone window intracranial hematoma removal for hypertensive cerebral hemorrhage.Methods A total of 40 hypertensive cerebral hemorrhage patients were divided into control group and observation group by random double-blind method,with 20 cases in each group.The control group was treated by large bone flap craniotomy for hematoma removal,and the observation group was treated by small bone window intracranial hematoma removal.The perioperative correlation indexes(hematoma clearance,hospitalization time and operation time),clinical efficacy,short-form-36 health survey(SF-36)score and occurrence of postoperative complications were compared between the two groups.Results The hospitalization time(20.40±4.15)d and operation time(60.90±12.50)min in the observation group were shorter than(30.50±6.50)d and(183.20±26.88)min in the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment 60.00% in the observation group was higher than 25.00% in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of vitality,social function,mental health,emotional function,physiological function,overall health,physical pain and physiological function of the two groups were improved,and the scores of vitality,social function,mental health,emotional function,physiological function,overall health,physical pain and physiological function of the observation group was higher than those of the control group.Their difference was statistically significant(P<0.05).The total incidence of complications was 20.00% in the observation group,which was lower than 55.00% in the control group,and the difference was statistically significant(P<0.05).Conclusion Small bone window intracranial hematoma removal shows remarkable effect for patients with hypertensive cerebral hemorrhage,and it can greatly improve the quality of life of patients.It has high clinical application value.