小骨窗开颅术在高血压脑出血治疗中的效果研究

Craniotomy of the Ossochoid Window in the Treatment of Hypertensive Intracerebral Hemorrhage Effect and Safety Analysis

探究高血压脑出血(HICH)治疗中小骨窗开颅术应用的有效性与安全性。采集68例HICH患者进行回归性分析。根据手术疗法将其分为两组,一组行大骨瓣开颅术治疗并命名为“大骨瓣组”,一组行小骨窗开颅术治疗并命名为“小骨窗组”,观察比较两组治疗结果。结果显示,小骨窗组手术相关指标水平优于大骨瓣组(P<0.05);血肿清除率(94.64±4.47%)高于大骨瓣组(89.28±4.32%)(P<0.05),术后1d、3d、7d颅内压与大骨瓣组无统计学差异(P>0.05);术后6个月NIHSS、FMA、ADL评分与大骨瓣组相比(P<0.05);总有效率94.12%,高于大骨瓣组76.47%(P<0.05);随访末期GCS、SSS评分与大骨瓣组相比(P<0.05);术后并发症发生率5.88%,低于大骨瓣组23.53%(P<0.05)。研究发现,小骨窗开颅术具备手术时间短、出血少、损伤小、恢复快等优势,其在HICH治疗中的有效应用可提高血肿清除率,获取较好治疗与预后效果。

To investigate the effectiveness and safety of hypertensive intracerebral hemorrhage(HICH)in the treatment of small and medium-sized bone window craniotomy.A total of 68 patients with HICH were collected for regression analysis.According to the surgical treatment,they were divided into two groups,one group was treated with a large bone flap craniotomy and named“large bone flap group”,and the other group was treated with a small bone window craniotomy and named“small bone window group”.The treatment results of the two groups were observed and compared.The level of surgery-related indexes in the small bone window group was better than that in the large bone flap group(P<0.05),the hematoma clearance rate(94.64±4.47%)was higher than that in the large bone flap group(89.28±4.32%)(P<0.05),and there was no statistical difference in intracranial pressure between the large bone flap group and the large bone flap group at 1 day,3 days and 7 days after surgery(P>0.05),the scores of NIHSS,FMA and ADL at 6 months after surgery were compared with those in the large bone flap group(P<0.05),and the total effective rate was 94.12%,which was higher than that in the large bone flap group(76.47%)(P<0.05);Compared with the large bone flap group at the end of follow-up,the GCS and SSS scores were compared with those in the large bone flap group(P<0.05),and the postoperative complication rate was 5.88%,which was lower than that in the large bone flap group(23.53%)(P<0.05).It has been found that the craniotomy of small bone window has the advantages of short operation time,less bleeding,less damage and fast recovery,and its effective application in the treatment of HICH can improve the hematoma clearance rate and obtain better treatment and prognostic effects.