小骨窗开颅血肿清除术与微创血肿碎吸术治疗高血压脑出血的临床疗效比较  

Comparison of the Curative Effect of Hematoma Evacuation by Small Bone window Craniotomy and Minimally Invasive Hematoma Aspiration on the Hypertensive Intracerebral Hemorrhage

作　　者：王铁峰 王刚[1] 崔海随 陈伦宁 杨昌立 WANG Tie-feng;WANG Gang;CUI Hai-sui;CHEN Lun-ning;YANG Chang-li(Neurosurgery Department,The second people's Hospital of Hainan,Wuzhishan,Hainan,572299,China)

机构地区：[1]海南省第二人民医院神经外科,海南五指山572299

出　　处：《现代生物医学进展》2019年第3期502-505,559,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金青年科学基金项目(81703683)

摘　　要：目的:观察和比较小骨窗开颅血肿清除术与微创血肿碎吸术治疗高血压脑出血的临床疗效和安全性。方法:选择2014年9月-2017年6月在我院接受手术治疗的60例高血压脑出血患者,随机分为对照组和研究组,每组各30例。对照组行小骨窗开颅血肿清除术,研究组行微创血肿碎吸术手术,比较两组血肿清除率、残余血肿量、再出血发生率、手术时间、住院时间、术中失血量及术后并发症发生率。结果:两组患者术后48h及7d血肿清除率、残余血肿量相比差异均无统计学意义(P>0.05)。对照组再出血发生率与研究组,但差异无统计学意义(P>0.05)。研究组的手术时间和住院时间与对照组相比显著缩短(P<0.05),术中失血量及术后并发症发生率较对照组显著下降(P<0.05)。术后3个月及6个月,两组患者日常生活能力显著改善(P<0.05),且研究组ADL评分显著高于对照组(P<0.05)。两组术后NFD评分逐渐降低,与术前比较差异具有统计学意义(P<0.05),在术后1个月与3个月,研究组NFD评分均显著低于对照组(P<0.05)。结论:采用微创血肿穿刺吸碎术治疗高血压脑出血的创伤小,疗效显著,可有效改善患者日常生活能力。Objective: To observed and compare the curative effect and safety between hematomaevacuation bysmallbone window craniotomy and min imally invasive hematoma aspiration for hypertensive intracerebral hemorrhage. Methods: 60 cases of patients with hypertensive intracerebral hemorrhage treated in our hospital from September 2014 to June 2017 were selected as research subjects and randomly divided into the control group and the study group, 30 cases in each group. The control group was given craniotomy with small bone window craniotomy. The study group was given minimally invasive hematoma aspiration surgery. The incidence of hematoma clearance, residual hematoma, rehemorrhage rate, operation time, hospital stay, intraoperative blood loss and postoperative complication rate of two group were compared. Results: The 48 h and 7 d hematoma clearance rates and the amount of residual hematoma showed no statistically difference between the two groups(P>0.05). There was no significant difference in the rehemorrhage rate between the two groups after operation(P>0.05). Compared with the control group, the operation time and hospitalization time were significantly shortened(P <0.05). The amount of peroperative hemorrhage in control group was significantly higher in the study group(P <0.05). And the incidence of postoperative complications was significantly lower in the study group than that of the control group(P <0.05). Before surgery, the ADL score showed no significant difference between the two groups(P>0.05). At 3 months and 6 months after treatment, the ability of daily life of two groups of patients were significantly improved(P<0.05), and the ADL score of study group was significantly higher than that of the control group(P<0.05). Compared with before surgery, the NFD score of two groups were significantly decreased after surgery(P<0.05), at 3 months and 6 months after treatment, the NFD scores of study group were significantly lower than those of the control group(P<0.05). Conclusions: Minimally invasive hematoma aspira

关 键 词：小骨窗开颅血肿清除术 微创血肿碎吸术 高血压脑出血 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]