小骨窗开颅术治疗高血压脑出血的效果

Effect of Small Bone Window Craniotomy in the Treatment of Hypertensive Cerebral Hemorrhage

目的:分析小骨窗开颅术在高血压脑出血中的应用价值。方法:回顾性选取2021年1月—2022年1月山东省第二人民医院神经外科收治的62例高血压脑出血患者的资料。根据不同的手术方法将其分为对照组(30例)和观察组(32例)。对照组采取传统骨瓣开颅术治疗,观察组采取小骨窗开颅术治疗。比较两组围手术期指标、相关指标,术前及术后1周神经功能情况,随访半年生活能力及运动能力。结果:观察组手术时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组血肿完全清除占比高于对照组,术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后1周,观察组美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,差异有统计学意义(P<0.05)。随访半年,观察组日常生活能力量表(ADL)评分、Fugel-Meyer运动功能评分量表(FMA)评分均高于对照组,差异有统计学意义(P<0.05)。结论:小骨窗开颅术相比于传统骨瓣开颅术来说,可以减少手术带来的损伤,降低并发症发生率,从而改善患者的神经功能,有助于提高患者远期疗效,促使患者尽早恢复正常生活。

Objective:To analyze the application value of small bone window craniotomy in hypertensive cerebral hemorrhage.Method:The data of 62 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery of the Second People's Hospital of Shandong Province from January 2021 to January 2022 were retrospectively selected.According to different surgical methods,they were divided into control group(30 cases)and observation group(32 cases).The control group was treated with traditional bone flap craniotomy,and the observation group was treated with small bone window craniotomy.The perioperative indexes,related indexes,neurological function before and 1 week after surgery,life ability and motor ability followed up for half a year of the two groups were compared.Result:The operation time and hospitalization time of the observation group were shorter than those of the control group,and the amount of intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).The proportion of hematoma complete clearance in the observation group was higher than that in the control group,and the incidence of postoperative complications was lower than that in the control group,and the differences were statistically significant(P<0.05).At 1 week after surgery,the National Institutes of Health stroke scale(NIHSS)score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After half a year of follow-up,the scores of activity of daily living scale(ADL)and Fugel-Meyer motor function scale(FMA)in the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Compared with traditional bone flap craniotomy bone flap removal,small bone window craniotomy can reduce the injury caused by surgery,reduce the incidence of complications,so as to improve the neurological function of patients,help to improve the long-term efficacy of patients,promote patients to return to normal life as soon as possible.