分析超早期小骨窗开颅手术在高血压脑出血患者中的应用效果  

Analysis of the Effect of Ultra-early Small Bone Window Craniotomy in Patients with Hypertensive Intracerebral Hemorrhage

作　　者：陈祥[1] CHEN Xiang(Department of Neurosurgery,Funing County People's Hospital,Yancheng,Jiangsu Province,224400 China)

机构地区：[1]阜宁县人民医院神经外科,江苏盐城224400

出　　处：《系统医学》2021年第18期126-128,共3页Systems Medicine

摘　　要：目的观察超早期小骨窗开颅手术在高血压脑出血患者中的应用效果及临床预后影响。方法选取2019年1月—2020年6月该院收治的84例高血压性脑出血患者为研究对象,患者入院后均接受小骨窗开颅手术治疗。依据患者手术时机差异分为对照组、观察组,各42例。比较患者手术期间血肿体积变化,手术前后神经功能损伤、GCS评分、FMA评分、ADL评分变化及手术效果、预后差异。结果观察组术后第2、3、4天血肿体积均小于对照组,差异有统计学意义(P<0.05);观察组术后15 d时NIHSS评分较同期对照组降低明显,GCS评分、FMA评分、ADL评分较同期对照组均显著提升,差异有统计学意义(P<0.05);观察组术后血肿清除有效率为95.24%,显著高于对照组的80.95%,差异有统计学意义(χ^(2)=4.086,P<0.05)。结论高血压性脑出血患者予以超早期小骨窗开颅手术治疗,可有效提升患者颅内血肿清除效果,降低脑组织及神经功能损伤程度,手术治疗效果显著。Objective To observe the effect and clinical prognosis of ultra-early small bone window craniotomy in patients with hypertensive cerebral hemorrhage.Methods 84 patients with hypertensive intracerebral hemorrhage treated in the hospital from January 2019 to June 2020 were selected as the research objects.All patients received small bone window craniotomy after admission.The patients were divided into control group and observation group according to the difference of operation time,with 42 cases in each group.The changes of hematoma volume,neurological injury,GCS score,FMA score,ADL score,surgical effect and prognosis were compared.Results The hematoma volume of the observation group on the 2nd,3rd and 4th day after operation was smaller than that of the control group,the difference was statistically significant(P<0.05).At 15 d after operation,NIHSS score in the observation group was significantly lower than that in the control group at the same time,and GCS score,FMA score and ADL score were significantly higher than those in the control group at the same time,and the difference was statistically significant(P<0.05).The effective rate of postoperative hematoma removal in the observation group was 95.24%,which was significantly higher than that of the control group 80.95%,the difference was statistically significant(χ^(2)=4.086,P<0.05).Conclusion Ultra-early small bone window craniotomy for patients with hypertensive intracerebral hemorrhage can effectively improve the clearance of intracranial hematoma,reduce the degree of brain tissue and nerve function damage,and the surgical treatment effect is significant.

关 键 词：超早期小骨窗开颅手术 高血压脑出血 临床效果 NIHSS 手术预后 

分 类 号：R4[医药卫生—临床医学]