显微镜下小骨窗开颅术对高血压脑出血的临床疗效及患者近期预后与生活质量的影响  

Clinical effect of small bone window craniotomy for hypertensive intracerebral hemorrhage and its influence on short-term prognosis and quality of life

作　　者：赵建伍 王兆斌[1] 薛勇[1] 赵学俊[1] ZHAO Jian-wu;WANG Zhao-bin;XUE Yong;ZHAO Xue-jun(Department of Neurosurgery,Puyang Oilfield General Hospital,Puyang,Henan 457001,China)

机构地区：[1]濮阳市油田总医院神经外科,河南濮阳457001

出　　处：《医药论坛杂志》2022年第20期44-47,共4页Journal of Medical Forum

摘　　要：目的 分析显微镜下小骨窗开颅手术治疗高血压脑出血的疗效。方法 选取2019年3月至2021年3月濮阳市油田总医院神经外科收治的64例高血压脑出血未形成脑疝的患者为研究对象,按采用手术方法不同,将应用传统大骨瓣开颅手术治疗的32例作为对照组,将应用显微镜下小骨窗开颅手术治疗的32例作为研究组,对比两种术式的应用效果。结果 研究组患者治疗总有效率(93.75%)高于对照组(71.88%),手术时间和住院时间短于对照组,切口长度小于对照组,术中出血量少于对照组,术后1个月NIHSS评分(神经功能缺损评分)明显低于对照组,GCS(格拉斯哥昏迷评分表)、ADL(日常生活活动能力评分表)、FMA评分(肢体运动功能测评表)明显高于对照组,术后2周白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平低于对照组,术后并发症发生率(12.50%)低于对照组(34.38%),组间比较P<0.05。结论 显微镜下小骨窗开颅手术对于治疗高血压脑出血具有很好的临床疗效,有助于改善患者预后和生活质量。Objective To analyze the effect of small bone window craniotomy on hypertensive cerebral hemorrhage under microscope.Methods Selection from March 2019 to March 2021 in Puyang Oil Field general hospital neurosurgery treated 64 cases of hypertension cerebral hemorrhage patients who were not form cerebral hernia as the research object, according to the different surgical methods, applied traditional big bone flap craniotomy surgery treatment of 32 cases as control group, the application of small bone window craniotomy under a microscope surgical treatment of 32 cases as a team, compared the application effect of two kinds of operative methods.Results The total effective rate(93.75%) of the study group was higher than that of the control group(71.88%),the operation time and hospitalization time were shorter, the incision length was shorter, the intraoperative blood loss was less than that in the control group, and the NIHSS score(neurological deficit score) one month after surgery was significantly lower than that of the control group.GCS(Glasgow Coma Scale),ADL(Daily Living activity Scale),FMA score(limb movement function scale) were significantly higher than those of the control group, the levels of IL-6,HS-CRP and TNF-α were lower than those of the control group 2 weeks after operation, and the incidence of postoperative complications(12.50%) was lower than that of the control group(34.38%),P<0.05.Conclusion Microscopically small bone window craniotomy has a good clinical effect on the treatment of hypertensive intracerebral hemorrhage, which is helpful to improve the prognosis and quality of life of patients.

关 键 词：高血压脑出血 显微镜下小骨窗开颅手术 传统大骨瓣开颅手术 

分 类 号：R651.1[医药卫生—外科学]