小骨窗微创手术对高血压脑出血患者的影响  

Effect of Small Bone Window Minimally Invasive Surgery on Hypertensive Intracerebral Hemorrhage

作　　者：邓建宏 黄金生男 DENG Jianhong;HUANG Jinshengnan(Department of Neurosurgery,Guangze County Hospital,Guangze 354100,Fujian Province,China)

机构地区：[1]福建省光泽县医院神经外科,福建光泽354100

出　　处：《中国实用乡村医生杂志》2022年第11期46-50,共5页Chinese Practical Journal of Rural Doctor

摘　　要：目的观察小骨窗微创手术对高血压脑出血患者格拉斯哥预后评分(GCS)评分、日常生活能力的影响。方法选择2020年1月—2022年1月于福建省光泽县医院收治的60例高血压脑出血患者,采用随机数字表法分为传统治疗组和研究组各30例。传统治疗组采用传统开颅血肿清除术治疗,研究组采用小骨窗脑出血清除术治疗,记录两组患者手术时间、术中出血量、90%以上血肿清除率、血肿清除90%以上时间、住院时间;术前、术后7 d给予患者临床神经功能缺损评分量表(CSS)评价,测量颅内压;术前、术后6个月给予患者脑电图评分(EEG)、CSS、蒙特利尔认知评估量表(MoCA)、功能综合评定量表(FCA)、改良Barthel指数评定量表(MBI)、改良Rankin量表(mRS)评价;记录两组患者再次出血、肺部感染、伤口感染、颅内感染等发生情况。结果研究组术中出血量比传统治疗组少(P<0.05),手术时间、血肿清除90%以上时间、住院时间比传统治疗组短(P<0.05),90%以上血肿清除率比传统治疗组高(P<0.05);术后7d,研究组GCS评分比传统治疗组高(P<0.05),研究组患者颅内压比传统治疗组低(P<0.05);术后6个月,研究组MoCA、EEG、FCA、MBI评分比传统治疗组高(P<0.05),研究组CSS、mRS评分比传统治疗组低(P<0.05),研究组并发症发生率比传统治疗组低(P<0.05)。结论小骨窗微创手术治疗高血压脑出血患者,可减轻手术损伤,提升血肿清除效果,促进脑部功能、神经功能、认知功能恢复,提升日常生活能力,改善预后,减少并发症。Objective To observe the effect of minimally invasive surgery with small bone window on Glasgow outcome scale(GCS)and activities of daily living(ADL)in patients with hypertensive intracerebral hemorrhage.Methods A total of 60 patients with hypertensive intracerebral hemorrhage were treated in Guangze County Hospital from January 2020 to January 2022.All patients were randomly divided into traditional group(n=30 cases)and study group(n=30 cases)based on random digital table method.The traditional group adopted the traditional craniotomy hematoma clearance,while the study group adopted small bone window cerebral hemorrhage clearance treatment.The time of operation,amount of bleeding during operation,clearance rate of hematoma above 90%,clearance time of hematoma above 90%and hospital stay were recorded.EEG,CSS,MoCA,FCA,MBI and mRS were used to evaluate the patients before and 6 months after operation,and the incidence of rebleeding,pulmonary infection,wound infection and intracranial infection were recorded.Results Compared with the traditional group,the study group had less blood loss during operation(P<0.05),shorter operation time,f hematoma clearance above 90%time and hospital stay(P<0.05),and higher clearance rate of more than 90%hematoma(P<0.05).The GCS score in the study group was significantly higher than that in the traditional treatment group 7 days after operation(P<0.05),and the intracranial pressure in the study group was significantly lower than that in the traditional treatment group(P<0.05).At 6 months after operation,the scores of MoCA,EEG,FCA and MBI in the study group were significantly higher than those in the traditional group(P<0.05),while the scores of CSS and mRS in the study group were significantly lower than those in the traditional group(P<0.05),the incidence of complications in the study group was significantly lower than that in the traditional group(P<0.05).Conclusion Small bone window minimally invasive surgery for hypertensive intracerebral hemorrhage can alleviate the injury of oper

关 键 词：小骨窗微创手术 高血压脑出血 血肿清除 神经功能 提升日常生活能力 并发症 

分 类 号：R651.1[医药卫生—外科学]