微创小骨窗开颅显微镜下血肿清除术治疗非脑疝形成高血压脑出血的效果  

Effect of minimally invasive craniotomy with microscopic hematoma in the treatment of hypertensive intracerebral hemorrhage without herniation

作　　者：李剑平[1] 胡海 罗慧强 廖振华[1] LI Jian-ping;HU Hai;LUO Hui-qiang;LIAO Zhen-hua(Xingguo County People's Hospital,Ganzhou City,Jiangxi Province,342400,China)

机构地区：[1]兴国县人民医院,江西赣州342400

出　　处：《蛇志》2022年第2期192-194,202,共4页Journal of Snake

基　　金：赣州市指导性科技计划(项目名称:微创小骨窗开颅显微镜下血肿清除术治疗非脑疝形成时高血压脑出血的效果探讨;项目编号:GZ2021ZSF699)。

摘　　要：目的探讨微创小骨窗开颅显微镜下血肿清除术治疗非脑疝形成高血压脑出血的效果。方法选择2020年1月~2021年8月我院收治的82例非脑疝形成高血压脑出血患者作为研究对象,按随机数字表法分为治疗组和对照组,每组41例。对照组行传统大骨瓣开颅手术治疗,治疗组行微创小骨窗开颅显微镜下血肿清除术治疗,比较两组血肿清除率、手术时间、手术费用、并发症发生率与治疗前后日常生活能力(BI)评分、神经功能(NIHSS)评分、肢体运动功能(FMAS)评分情况。结果治疗组的血肿清除率高于对照组,差异有统计学意义(P<0.05)。治疗组的手术时间短于对照组,且手术费用、并发症发生率均低于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组的BI、NIHSS、FMAS评分比较,差异无统计学意义(均P>0.05);治疗后,治疗组的BI、FMAS评分均高于对照组,NIHSS评分低于对照组,差异均有统计学意义(均P<0.05)。结论微创小骨窗开颅显微镜下血肿清除术治疗非脑疝形成高血压脑出血的临床效果显著,能有效减轻机体神经功能损伤程度,提高患者日常生活能力及肢体运动功能,且并发症发生率低,有利于促进患者康复,值得临床应用。Objective To analyze the effect of hematoma debridement under the minimally invasive small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage without herniation.Methods From January 2020 to August 2021,82 patients with hypertensive cerebral hemorrhage without herniation in our hospital were selected as the research subjects.They were divided into a treatment group and a reference group by lottery,with 41 cases in each group.The reference group was treated with traditional large bone flap craniotomy,while the treatment group was treated with minimally invasive small bone window craniotomy under microscope to remove hematoma.The hematoma clearance rate,operation time,operation cost,complication rate,daily living ability(BI)score,neurological function(NIHSS)score and limb motor function(FMAS)score before and after treatment were compared between the two groups.Results The hematoma clearance rate in the treatment group was higher than that in the reference group(P<0.05).The operation time of the treatment group was shorter than that of the reference group,and the operation cost and complication rate were lower than those of the reference group,and the data comparison between the groups was statistically significant(P<0.05 for each).There was no difference in BI,NIHSS,and FMAS scores between the two groups before treatment(P>0.05).After treatment,the BI and FMAS scores in the treatment group were higher than those in the reference group,and the NIHSS score was lower than that in the reference group(P<0.05 for both).Conclusion The minimally invasive small bone window craniotomy microscopic hematoma debridement has a significant clinical effect in the treatment of hypertensive intracerebral hemorrhage caused by non-brain herniation,which can effectively reduce the degree of neurological damage,improve the patients'daily life ability and limb motor function and the complications.The incidence of the disease is low,which is conducive to the quick recovery of patients,and is worthy of clinical

关 键 词：小骨窗开颅术 显微镜 血肿清除术 非脑疝形成 高血压脑出血 

分 类 号：R651.1[医药卫生—外科学]