文章摘要

小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血的 临床疗效对比

作者: 1刘 彬
1 宿州市第一人民医院脑血管病诊疗中心,安徽 宿州 234000
通讯: 刘 彬 Email: 194198520@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.01.017

摘要

目的:比较小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血的临床疗效。方法:选取2016年9月至2017年9月就诊于宿州市第一人民医院的100例高血压脑出血患者。按随机分配原则分为微创组(50例)和常规组(50例),微创组接受小骨瓣开颅血肿清除术,常规组接受传统大骨瓣开颅血肿清除术。观察比较两组围手术期情况、临床疗效、术后6个月神经功能缺损情况、术后6个月生活能力情况及随访1年期间并发症、再出血、血肿残留情况。结果:微创组术中切口直径、出血量、手术时间、出血清除率、术后ICU住院时间、术后普通病房住院时间均优于常规组(P<0.05);微创组术后总有效率优于常规组(P<0.05),两组术后并发症及血肿残留差异无统计学意义(P>0.05),微创组术再出血率明显低于常规组(P<0.05);手术前,两组美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)评分差异无统计学意义(P>0.05),微创组术后6个月NIHSS评分明显降低并优于常规组(P<0.05);手术前,两组ADL评分差异无统计学意义(P>0.05),微创组术后6个月ADL评分明显升高并优于常规组(P<0.05)。结论:相较于大骨瓣开颅血肿清除术治疗高血压脑出血,小骨窗瓣开颅血肿清除术创伤小、患者术后恢复快、临床疗效好、术后并发症少,优势显著,值得临床推广。
关键词: 小骨窗瓣开颅血肿清除术;大骨瓣开颅血肿清除术;高血压脑出血;疗效

A comparative study on clinical efficacy of small bone window craniotomy and large bone flap craniotomy in the treatment of hypertensive intracerebral hemorrhage

Authors: 1LIU Bin
1 Cerebrovascular Disease Diagnosis and Treatment Center, Suzhou First People’s Hospital, Suzhou Anhui 234000, China

CorrespondingAuthor:LIU Bin Email: 194198520@qq.com

Abstract

Objective: To investigate the clinical efficacy of small bone window craniotomy and large bone flap craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods: A total of 100 cases with hypertensive intracerebral hemorrhage from September 2015 to September 2016 in Suzhou First People’s Hospital were included. The minimally invasive group (50 cases) received minimally invasive small bone flap craniectomy, and the conventional group (50 cases)received traditional large bone flap craniectomy. Compare the perioperative condition, clinical efficacy, neurological deficits and living capacity after 6 months postoperatively, and complications, rebleeding, hematoma residue during the 1-years’follow-up period between the two groups. Results: The diameter of incision, bleeding, duration of operation, bleeding free rate, duration of ICU stay and duration of hospital stay in the general ward were better than those in the conventional group (P<0.05). The total effective rate of minimally invasive group was higher than that of routine group (P<0.05). There was no significant difference of complications and residual hematoma between the two groups (P>0.05). And the rate rebleeding of minimally invasive group was lower than conventional group (P<0.05). The NIHSS score of the minimally invasive group was significantly lower than that of the conventional group (P<0.05). The ADL score of the minimally invasive group was significantly higher than that of the conventional group (P<0.05). Conclusion: Compared with the large bone flap craniotomy, the small bone window craniotomy had advantages in the treatment of hypertensive intracerebral hemorrhage such as less traumatic, faster postopearative recovery, better clinical efficacy, few complications. In a word, small bone window craniotomy is worthy to promotion.
Keywords: small bone window craniectomy; large bone flap craniotomy; hypertensive intracerebral hemorrhage; efficacy