超早期小骨窗微创脑出血清除术对高血压脑出血患者血肿清除率、并发症发生率的影响  

Effect of Ultra-early Small Bone Window Minimally Invasive Intracere⁃bral Hemorrhage Clearance Surgery on Hematoma Clearance Rate and In⁃cidence of Complications in Patients with Hypertensive Intracerebral Hemorrhage

作　　者：杨文强 谢永兴 YANG Wenqiang;XIE Yongxing(Neurosurgery Department,Dunhuang Hospital,Dunhuang 736200,Gansu,China)

机构地区：[1]敦煌市医院神经外科,甘肃敦煌736200

出　　处：《系统医学》2025年第6期111-114,126,共5页Systems Medicine

摘　　要：目的探究超早期小骨窗微创脑出血清除术(ultra-early small bone window minimally invasive cerebral hemorrhage clearance,EMIHE)治疗高血压脑出血(hypertensive intracerebral hemorrhage,HICH)患者的效果。方法回顾性选取2017年1月—2023年1月敦煌市医院收治的92例HICH患者的临床资料,按术式不同分为两组,每组46例。对照组给予常规骨瓣开颅术治疗,观察组给予EMIHE治疗。比较两组血肿清除率、临床疗效、围术期指标、神经功能、炎性因子、血管内皮功能及并发症发生率。结果观察组血肿清除率为93.48%(43/46),高于对照组的76.09%(35/46),差异有统计学意义(χ^(2)=5.392,P=0.020)。观察组治疗总有效率高于对照组,并发症发生率低于对照组,差异有统计学意义(P均<0.05)。观察组围术期指标、神经功能、炎性因子、血管内皮功能均优于对照组,差异有统计学意义(P均<0.05)。结论HICH患者采用EMIHE治疗,相较于常规骨瓣开颅术效果更好,有助于优化围术期指标,减轻炎症反应,提高血管内皮功能、神经功能及血肿清除率,并减少并发症的发生。Objective To investigate the effectiveness of ultra-early small bone window minimally invasive cerebral hemorrhage clearance(EMIHE)in the treatment of patients with hypertensive intracerebral hemorrhage(HICH)pa-tients.Methods The clinical data of ninety-two HICH patients admitted to Dunhuang Hospital from January 2017 to January 2023 were retrospectively selected and divided into two groups according to the different surgical styles,with forty-six cases in each group.The control group was given conventional bone flap craniotomy treatment,and the obser-vation group was given EMIHE treatment.The haematoma clearance rate,clinical efficacy,perioperative indexes,neu-rological function,inflammatory factor,vascular endothelial function and complication rate were compared between the two groups.Results The haematoma clearance rate of the observation group was 93.48%(43/46),which was higher than 76.09%(35/46)of the control group,and the difference was statistically significant(χ^(2)=5.392,P=0.020).The to-tal effective rate of treatment in the observation group was higher than that of the control group,and the complication rate was lower than that of the control group,and the differences were statistically significant(both P<0.05).The peri-operative indexes,neurological function,inflammatory factor,and vascular endothelial function of the observation group were better than those of the control group,and the differences were statistically significant(all P<0.05).Con-clusion EMIHE treatment is more better than HICH patients compared to conventional craniotomy,which can help op-timize perioperative indicators,reduce inflammatory reactions,improve vascular endothelial function,nerve function,and hematoma clearance rate,and reduce the occurrence of complications.

关 键 词：高血压脑出血 超早期小骨窗微创脑出血清除术 并发症发生率 血肿清除率 

分 类 号：R651[医药卫生—外科学]