高血压幕上脑叶出血患者去留骨瓣手术效果对比  

Comparison of the Results of Retaining Bone Flap Surgery for Patients with Hypertension with Supratentorial Cerebral Hemorrhage

作　　者：吴晓宏[1] 邓明均[1] 金祥兵[1] 丁冬官 WU Xiao-hong;DENG Ming-jun;JIN Xiang-bing;DING Dong-guan(Department of Neurosurgery, Dongtai People's Hospital, Dongtai, Jiangsu Province, 224200 China)

机构地区：[1]东台市人民医院神经外科,江苏东台224200

出　　处：《中外医疗》2018年第35期13-15,共3页China & Foreign Medical Treatment

摘　　要：目的对比高血压幕上脑叶出血去留骨瓣手术的治疗效果。方法根据手术方法不同,将方便选取2015年3月—2017年7月在该院治疗的60例高血压幕上脑叶出血患者分为每组30例,均接受血肿清除术,对照组实施去骨瓣减压术,观察组采取留骨瓣减压术。对比两组术后并发症、住院天数以及神经功能的改善情况。结果观察组术后并发症总发生率(6.67%)低于对照组(χ2=4.32,P=0.04),术后住院天数(20.56±8.01)d,更短(t=4.86,P=0.01),术后3个月神经功能缺损各项目评分[意识:(20.15±1.10)分、面瘫:(19.53±1.12)分、水平凝视:(17.53±1.06)分、言语:(18.53±1.21)分、手部活动:(19.34±1.14)分、肩部活动:(18.52±1.16)分、下肢活动:(17.56±1.20)分、步行:(18.63±1.10)分]均比对照组低(P<0.05)。结论留骨瓣手术治疗高血压幕上脑叶出血的近远期效果均优于去骨瓣手术。Objective To compare the therapeutic effect of superficial cerebral hemorrhage on the operation of bone flap surgery.Methods According to different surgical methods,60 patients with hypertensive supratentorial lobe hemorrhage treated in the hospital from March 2015 to July 2017 were convenient selected and divided into 30 cases in each group.All patients underwent hematoma evacuation valve decompression,the observation group was treated with residual bone flap decompression.The postoperative complications,length of hospital stay,and improvement of neurological function were compared between the two groups.Results The total incidence of postoperative complications in the observation group (6.67%) was lower than that in the control group (χ^2= 4.32,P=0.04),and the postoperative hospital stay (20.56±8.01)d was shorter (t=4.86,P=0.01),scores of neurological deficits after three months of operation [consciousness:(20.15±1.10)points,facial paralysis:(19.53±1.12)points,horizontal gaze:(17.53±1.06)points,speech:(18.53±1.21)points,hand activity:(19.34± 1.14)points,shoulder activity:(18.52±1.16)points,lower limb activity:(17.56±1.20)points,walking:(18.63±1.10)points] were lower than the control group (P<0.05).Conclusion The short-term and long-term effects of residual bone flap surgery for supratentorial cerebral hemorrhage are better than bone surgery.

关 键 词：去留骨瓣手术 高血压 幕上脑叶出血 

分 类 号：R651.12[医药卫生—外科学]