不同手术方法治疗脑出血的临床疗效研究  

Study on the Clinical Efficacy of Different Surgical Methods in the Treatment of Cerebral Hemorrhage

作　　者：马茂华 MA Maohua(Department of Neurosurgery,Guangrao County People's Hospital,Dongying,Shandong Province,257300 China)

机构地区：[1]广饶县人民医院神经外科,山东东营257300

出　　处：《世界复合医学》2021年第4期24-27,共4页World Journal of Complex Medicine

基　　金：Lgr5在垂体腺瘤干细胞中的表达及致肿瘤性的研究(2015WS0512)。

摘　　要：目的对高血压脑出血患者采用不同手术方式治疗的效果进行探究。方法选择2018年6月—2020年2月该院收治的高血压脑出血患者120例作为该次研究对象,按照随机数表法将其划分为微创组(微创手术)和开放组(开放手术治疗),每组60例。比较两组患者的治疗效果。结果微创组的手术时间(1.1±0.2)h、术中出血量(86.4±19.3)mL和住院时间(24.2±5.6)d明显低于开放组(2.9±0.5)d、(231.6±48.5)mL、(37.3±5.7)d,差异有统计学意义(t=25.891、21.546、12.698,P<0.05);治疗后,微创组的GCS评分(3.9±0.3)分、血肿量(3.4±0.3)mL明显优于开放组(3.1±0.2)分、(9.6±1.5)m L,差异有统计学意义(t=17.186、31.394,P<0.05);微创组的术后并发症发生率(3.3%)明显低于开放组20.0%,差异有统计学意义(χ^(2)=8.086,P<0.05)。结论采用微创小骨窗开颅手术治疗高血压脑出血患者效果确切,能够有效减少其术中出血量,缩短其手术时间和住院时间,改善其血肿情况和GCS评分,而且并发症少,安全性高。Objective To explore the effects of different surgical treatments for patients with hypertensive intracerebral hemorrhage.Methods From June 2018 to February 2020120 patients with hypertensive intracerebral hemorrhage admitted to the hospital were selected as the subjects of this study.and they were divided into the minimally invasive group(invasive surgery)and open group(open surgery treatment)according to the random number table method,each group had 60 cases.Compared the treatment effect of the two groups of patients.Results The operation time(1.1±0.2)h,intraoperative blood loss(86.4±19.3)mL and hospitalization time(24.2±5.6)d in the minimally invasive group were significantly lower than those in the open group(2.9±0.5)d and(231.6±48.5)mL,(37.3±5.7)d,the difference was statistically significant(t=25.891,21.546,12.698,P<0.05);after treatment,the GCS score(3.9±0.3)points and hematoma volume(3.4±0.3)mL of the minimally invasive groupwas significantly better than the open group(3.1±0.2)points,(9.6±1.5)mL,the difference was statistically significant(t=17.186,31.394,P<0.05);the postoperative complication rate of the minimally invasive group 3.3%was significantly lower than 20.0%in the open group,and the difference was statistically significant(χ^(2)=8.086,P<0.05).Conclusion The minimally invasive small bone window craniotomy is effective in the treatment of patients with hypertensive cerebral hemorrhage.It can effectively reduce the amount of intraoperative blood loss,shorten the operation time and hospital stay,improve the hematoma and GCS score,and has fewer complications and high safety.

关 键 词：微创小骨窗开颅手术 高血压脑出血 围术期指标 血肿 GCS评分 并发症 

分 类 号：R651[医药卫生—外科学]