小骨窗开颅术治疗高血压基底节区脑出血的效果及对GCS评分的影响  

Effect of Small Bone Window Craniotomy on Hypertensive Basal Ganglia Cerebral Hemorrhage and Its Influence on GCS Score

作　　者：黄果 安岭 齐亮[2] HUANG Guo;AN Ling;QI Liang(Department of Neurosurgery,Lianshui County People's Hospital,Lianshui,Jiangsu,223400,China;Department of Neurosurgery,The Second People's Hospital of Huai'an City,Huai'an,Jiangsu,223000,China)

机构地区：[1]涟水县人民医院神经外科,江苏涟水223400 [2]淮安市第二人民医院神经外科,江苏淮安223000

出　　处：《中外医疗》2025年第3期23-26,共4页China & Foreign Medical Treatment

摘　　要：目的 探究小骨窗开颅术治疗高血压基底节区脑出血的效果及对格拉斯哥昏迷评分的影响。方法 方便选取2022年1月—2024年3月涟水县人民医院收治的78例高血压基底节区脑出血患者为研究对象,根据不同手术方式分为观察组、对照组,各39例。观察组采用小骨窗开颅术治疗,对照组采用锥颅引流术治疗,对比两组手术相关指标、疗效指标、昏迷程度和神经损伤程度。结果 观察组手术时间(51.36±2.55) min、住院时间(13.02±2.41) d均短于对照组的(125.63±10.85) min、(15.96±2.96) d,术中出血量(43.22±2.02) mL低于对照组的(73.52±3.85) mL,血肿清除率(76.88±3.41)%高于对照组的(56.25±2.01)%,差异均有统计学意义(t=41.465,4.646,42.723,30.535;P均<0.05)。观察组再出血率、住院期间病死率均低于对照组,差异均有统计学意义(P均<0.05)。治疗后,两组格拉斯哥昏迷评分和斯堪的纳维亚卒中量表评分优于治疗前,观察组优于对照组,差异均有统计学意义(P均<0.05)。结论 小骨窗开颅术治疗高血压基底节区脑出血效果较好,能有效改善患者的昏迷状态,清除血肿,对出血的血管有效地电凝止血,促进预后的改善。Objective To explore the effect of small bone window craniotomy on hypertensive basal ganglia hemor-rhage and its effect on Glasgow Coma Scale score.Methods A total of 78 patients with hypertensive basal ganglia hem-orrhage admitted to Lianshui County People's Hospital from January 2022 to March 2024 were conveniently selected as the research objects.According to different surgical methods,they were divided into observation group and control group,with 39 cases in each group.The observation group was treated with small bone window craniotomy,and the control group was treated with conical skull drainage.The operation related indexes,curative effect indexes,coma de-gree and nerve injury degree were compared between the two groups.Results The operation time(51.36±2.55)min and hospitalization time(13.02±2.41)d in the observation group were shorter than(125.63±10.85)min and(15.96±2.96)d in the control group,the intraoperative blood loss(43.22±2.02)mL was lower than(73.52±3.85)mL in the con-trol group,and the hematoma clearance rate(76.88±3.41)%was higher than(56.25±2.01)%in the control group,the differences were statistically significant(t=41.465,4.646,42.723,30.535;all P<0.05).The rebleeding rate and mortal-ity during hospitalization in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).After treatment,the scores of Glasgow Coma Scale and Scandinavian Stroke Scale in the two groups were better than those before treatment,and the observation group was better than the control group,the differences were statistically significant(both P<0.05).Conclusion Small bone window craniotomy is effec-tive in the treatment of hypertensive basal ganglia intracerebral hemorrhage.It can effectively improve the coma state of patients,remove hematoma,effectively electrocoagulation and hemostasis of bleeding vessels,and promote the im-provement of prognosis.

关 键 词：高血压基底节区脑出血 小骨窗开颅术 手术效果 格拉斯哥昏迷评分法 

分 类 号：R563[医药卫生—呼吸系统]