直视下锥孔引流与小骨窗开颅治疗高血压脑出血的临床对比研究  

Craniotomy with small bone window hole and open drainage in treatment of hypertensive cerebral hemorrhage: A clinical comparative study

作　　者：熊建平[1] 

机构地区：[1]浙江省建德市第一人民医院脑外科,浙江建德311600

出　　处：《中国现代医生》2013年第4期28-29,32,共3页China Modern Doctor

基　　金：浙江省医药卫生科学研究基金计划项目(2010KyA047)

摘　　要：目的对比探讨小骨窗开颅与直视下锥孔引流治疗高血压脑出血的可行性。方法选取我院近期确诊收治的120例高血压脑出血患者,严格限定入选标准将患者随机分为两组,其中研究组60例行小骨窗开颅术,对照组60例行直视下锥孔引流术,对比两组患者的围手术期临床指标、GOS临床评分及血清GFAP水平变化。结果两组间相比,研究组患者的血肿清除时间、并发症发生率、死亡率均低于对照组(P<0.05);且研究组患者的预后优良率为91.7%,高于对照组的83.3%(P<0.05);经过治疗后,两组血清GFAP水平都有明显提高,在第7天达到高峰(P<0.05);研究组在第7、14天显著低于对照组(P<0.05)。结论采用小骨窗开颅术治疗高血压脑出血,临床疗效显著,且安全性高,一般情况下优于直视下锥孔引流。Objective Comparative study of small bone window craniotomy with open hole drainage in treating hypertensive cerebral hemorrhage. Methods Selected recent diagnosed in our hospital 120 cases of hypertensive cerebral hemorrhage patients, strictly defined criteria for the patients were randomly divided into two groups, the study group 60 cases operation under direct vision hole drainage, the control group 60 cases of craniotomy with small bone window, compared two groups of patients during peri operation period of clinical indicators, GOS clinical score and changes of the serum level of GFAP. Results Among the two groups compared, study group of patients with hematoma removal time, complication rate, mortality rates were lower than the control group （P 〈 0.05 ） ; and the study group pa- tients prognosis is excellent rate of 91.7%, higher than that of control group 83.3% （P 〈 0.05 ） ; After the treatment, two groups of serum GFAP levels are increased, in seventh days to reach the peak （P 〈 0.05 ） ; Study group in seventh, 14 days was significantly lower than that of control group （P 〈 0.05）. Conclusion The open hole drainage in treatment of hypertensive cerebral hemorrhage, clinical efficacy, and the security is high, in general is better than that of small bone window craniotomy.

关 键 词：小骨窗开颅 直视下锥孔引流 高血压脑出血 

分 类 号：R651.12[医药卫生—外科学]