小骨窗颅内血肿清除术治疗高血压性脑出血的临床观察

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

目的探讨小骨窗颅内血肿清除术治疗高血压性脑出血的临床疗效。方法选择2019年2月至2020年2月本院收治的71例高血压性脑出血患者作为研究对象,采用随机摸球法随机分为观察组(n=35)与对照组(n=36)。对照组采用大骨瓣开颅血肿清除术治疗,观察组采用小骨窗颅内血肿清除术治疗,比较两组术中出血量、手术时间、血肿清除率、健康状况调查问卷(SF-36)及术后并发症发生情况。结果观察组术中出血量少于对照组,手术时间短于对照组,血肿清除率高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.71%,低于对照组的22.22%,差异有统计学意义(P<0.05);观察组出院后生理功能、健康状况、情感职能、社会功能评分明显高于对照组,差异有统计学意义(P<0.05)。结论小骨窗开颅血肿清除术治疗高血压脑出血具有手术时间短、血肿清除率高、并发症发生率低、术中出血量少等优点,能提高患者术后生命质量,值得临床推广应用。

Objective To investigate the clinical effect of small bone window intracranial hematoma removal for hypertensive cerebral hemorrhage.Methods 71 patients with hypertensive cerebral hemorrhage admitted to our hospital from February 2019 to February 2020 were selected as the research subjects,and they were randomly divided into the observation group(n=35)and the control group(n=36).The control group was treated with large bone flap craniotomy for hematoma removal,and the observation group was treated with small bone window intracranial hematoma removal.The intraoperative blood loss,operation time,hematoma removal rate,36-item short-form(SF-36)score and postoperative complications were compared between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group,the operation time was shorter than that in the control group,and the hematoma clearance rate was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 5.71%,which was lower than 22.22%in the control group,and the difference was statistically significant(P<0.05).The scores of physiological function,health status,emotional function and social function in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Small bone window craniotomy for hematoma removal for hypertensive cerebral hemorrhage has the advantages of short operation time,high hematoma removal rate,low complication rate,and less intraoperative blood loss,it can improve the quality of life of patients after surgery,and worthy of clinical promotion and application.