显微镜下小骨窗开颅血肿清除术治疗高血压脑出血的效果分析

Analysis of the Effect of Small Bone Window Craniotomy to Remove Hematoma in the Treatment of Hypertensive Cerebral Hemorrhage

目的:评价显微镜下小骨窗开颅血肿清除术治疗高血压脑出血疾病的临床优势。方法:选择2019年7月~2020年4月本院诊治的高血压脑出血患者92例,按照入院先后顺序分为对照组(n=46,大骨瓣开颅血肿清除术治疗)、观察组(n=46,显微镜下小骨窗开颅血肿清除术治疗),比较2组高血压脑出血患者的手术时间、术中出血量等情况。结果:组间手术相关指标比较,观察组患者手术、住院时间、出血量均少于对照组,P<0.05;组间术后肺部感染等并发症比较,观察组发生率(4.34%)少于对照组(26.08%),P<0.05;患者日常生活能力分级情况比较,按照日常生活能力评定,观察组明显优于对照组,P<0.05;神经功能缺损程度按照临床神经功能缺损程度评估,观察组评分(22.20±2.50)分少于对照组(33.50±3.50)分,P<0.05。结论:显微镜下小骨窗开颅血肿清除术治疗高血压脑出血手术损伤小、术后恢复快、患者日常生活能力恢复良好,且手术安全性高,是理想术式。

Objective:To evaluate the clinical advantages of small bone window craniotomy under the microscope for the treatment of hypertensive intracerebral hemorrhage.Methods:Patients with hypertensive cerebral hemorrhage(n=92)diagnosed and treated in our hospital from July 2019 to April 2020 were selected and divided into control group(n=46,large bone flap craniotomy for hematoma removal according to the order of admission),observation group(n=46,treatment of small bone window craniotomy under microscope for hematoma removal),compare the operation time and intraoperative blood loss of the two groups of hypertensive intracerebral hemorrhage patients.Results:Comparing the related indexes of surgery between the groups,the patients in the observation group were less than those in the control group in terms of surgery,hospital stay,and blood loss,P<0.05.Comparing postoperative complications such as lung infection between the groups,the observation group had less incidence(4.34%)Compared with the control group(26.08%),P<0.05;Comparison of the grading of the patients’activities of daily living according to the activities of daily living(ADL),the observation group is significantly better than the control group,P<0.05;The degree of neurological deficit is based on the clinical neurological function In the evaluation of the degree of defect(Clinical neurological deficit score,NDS),the score of the observation group(22.20±2.50)was lower than that of the control group(33.50±3.50),P<0.05.Conclusion:Microscopic small bone window craniotomy for the treatment of hypertensive intracerebral hemorrhage has minimal surgical damage,quick postoperative recovery,good recovery of the patient’s ability of daily living,and high surgical safety.It is an ideal operation.