改良小骨窗手术与传统术式清除高血压基底节区脑出血血肿的效果  

Efficacy of modified small-window craniotomy versus conventional craniotomy for evacuation of hematoma in hypertensive basal ganglia hemorrhage

作　　者：刘家凯[1] 杨炳湖[1] 罗洪海[1] 

机构地区：[1]惠州市中心人民医院神经外科,广东惠州516000

出　　处：《广州医科大学学报》2016年第2期59-62,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:比较改良小骨窗手术与传统术式清除高血压基底节区脑出血血肿效果。方法:以我院2013年1月-2014年6月期间收治85例高血压基底节区脑出血血肿患者为例,分为观察组(n=48)与对照组(n=47),对照组行大骨瓣开颅血肿清除术,观察组行改良小骨窗开颅血肿清除术,比较两组手术相关指标、住院时间;治疗有效率、并发症发生率。结果:两组手术时间、住院时间的比较差异无统计学意义(P>0.05):术中输血量[(87.4±30.5)VS(213.7±56.3)]m L,治疗有效率[(87.5%)VS(63.8%)],并发症发生率[(45.8%)VS(75.6%)],差异均有统计学意义(P<0.05)。结论:与传统术式相比,改良小骨窗开颅术治疗高血压基底节区脑出血血肿操作难度低、术后并发症少,效果更佳,且手术效果所受影响因素少,可作为首选手术方案。Objective：To compare the efficacy of modified small-window craniotomy versus conventional craniotomy for evacuation of hematoma in hypertensive basal ganglia hemorrhage. Methods： Included in this study were 85 patients with hypertensive basal ganglia hemorrhage treated in our hospital between January 2013 and June 2014,who were divided into the study group （n=48） and control group （n=47）. The patients in control group received hematoma evacuation via large bone flap craniotomy, while those in the study group via modified small-window craniotomy. The two groups were compared for surgery-related indicators, hospital stay, treatment efficacy, and complication rate. Results： The operative time and hospital stay were not statistically different between groups （P〉0.05）. Intraoperative blood transfusion was （87.4±30.5） mL vs （213.7±56.3） mL,rate of treatment efficacy was （87.5% vs 63.8%,and rate of complication was 45.8% vs 75.6%,in the study group vs the control group with statistically significant differences （all P〈0.05）. Conclusion： Compared with conventional surgery, the modified small-window craniotomy appears to be less operatively difficult, with fewer postoperative complications and better efficacy. Moreover,the treatment outcomes of this surgery are less affected by other factors. Therefore,the modified small-window craniotomy can be used as the first-line choice of surgical option.

关 键 词：骨窗 高血压 脑出血 血肿 压迫 

分 类 号：R743.34[医药卫生—神经病学与精神病学]