常规开颅对比钻孔引流及显微镜辅助小骨窗开颅对基底节区高血压脑出血患者的临床研究  

Comparison of Routine Craniotomy with Burr-hole Irrigation and Drainage and Microscope-assisted Small Bone Window Craniotomy in Patients with Basal Ganglia Hypertensive Intracerebral Hemorrhage

作　　者：张建海[1] 单毅华[1] 李仁满 ZHANG Jianhai;SHAN Yihua;LI Renman(Sanming City First Hospital,Sanming 365000,China;不详)

机构地区：[1]三明市第一医院,福建三明365000

出　　处：《中外医学研究》2021年第31期9-13,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析基底节区高血压脑出血(hypertensive intracerebral hemorrhage,HICH)行常规开颅术、显微镜辅助小骨窗开颅术及钻孔引流术治疗的临床效果。方法:回顾性分析2017年3月-2020年3月于笔者所在医院择期行手术治疗的96例基底节区HICH患者的临床资料,根据治疗方法的不同将其分为常规开颅组(32例)、小骨窗开颅组(32例)、钻孔引流组(32例)。常规开颅组行常规开颅术治疗,小骨窗开颅组行显微镜辅助小骨窗开颅术治疗,钻孔引流行钻孔引流术治疗。比较三组手术相关指标,近、远期疗效及术后并发症发生情况。结果:三组术后再出血率和血肿清除率比较差异均无统计学意义(P>0.05)。小骨窗开颅组和钻孔引流组手术时间、住院时间均明显短于常规开颅组,术中出血量均明显少于常规开颅组,差异有统计学意义(P<0.01),且钻孔引流组手术时间、住院时间、术中出血量均优于小骨窗开颅组,差异有统计学意义(P<0.01)。术后1个月,钻孔引流组优良率显著高于小骨窗开颅组和常规开颅组(P<0.05),但小骨窗开颅组与常规开颅组比较差异无统计学意义(P>0.05)。钻孔引流组预后良好率显著高于小骨窗开颅组和常规开颅组(P<0.05),但小骨窗开颅组与常规开颅组比较差异无统计学意义(P>0.05)。钻孔引流组术后并发症发生率显著低于小骨窗开颅组和常规开颅组(P<0.05),但小骨窗开颅组与常规开颅组比较差异无统计学意义(P>0.05)。结论:与常规开颅术、小骨窗开颅术相比,基底节区HICH患者应用钻孔引流术治疗创伤更小,近、远期疗效更佳,且安全可靠。Objective:To analysis the clinical effect of routine craniotomy,microscope-assisted small bone window craniotomy,and burr-hole irrigation and drainage in the treatment of basal ganglia hypertensive intracerebral hemorrhage(HICH).Method:The clinical data of 96 patients with basal ganglia HICH who underwent elective surgical treatment in our hospital from March 2017 to March 2020 were retrospectively analyzed.According to the different treatment methods,they were divided into the routine craniotomy group(32 cases),small bone window craniotomy group(32 cases),burr-hole irrigation and drainage group(32 cases).The routine craniotomy group was treated with routine craniotomy,small bone window craniotomy group was treated with microscope-assisted small bone window craniotomy,and burr-hole irrigation and drainage group was treated with burr-hole irrigation and drainage.The surgical indicators,short-term and long-term efficacy,and postoperative complications of the three groups were compared.Result:There was no significant difference in rebleeding rate and hematoma clearance rate among the three groups(P>0.05).The operation time,hospitalization time and intraoperative blood loss of small bone window craniotomy group and drilling drainage group were significantly shorter than those of conventional craniotomy group(P<0.01),and the operation time,hospitalization time and intraoperative blood loss of drilling drainage group were better than those of small bone window craniotomy group(P<0.01).One month after operation,the excellent and good rate of drilling drainage group was significantly higher than that of small bone window craniotomy group and conventional craniotomy group(P<0.05),but there was no significant difference between small bone window craniotomy group and conventional craniotomy group(P>0.05).The good prognosis rate of drilling drainage group was significantly higher than that of small bone window craniotomy group and conventional craniotomy group(P<0.05),but there was no significant difference between small bon

关 键 词：常规开颅术 小骨窗开颅术 钻孔引流术 基底节区高血压脑出血 

分 类 号：R651.1[医药卫生—外科学]