锥颅血肿清除术治疗高血压脑出血的临床效果

目的探讨锥颅血肿清除手术治疗102例高血压脑出血患者的临床疗效，为脑外科临床治疗提供指导。方法选取本院于2008年1月～2012年12月收治的高血压脑出血患者205例为研究对象，根据患者病情及治疗意愿将其分为常规开颅手术治疗组103例（对照组）以及行锥颅血肿清除手术组102例（观察组），对比分析两组患者手术治疗效果，术后对患者进行GCS评分，观察两组患者治疗前后GCS评分的变化。结果观察组患者手术时间、术中出血量、平均住院时间均优于对照组，差异具有统计学意义（P〈0．05）。观察组患者治疗后GCS评分显著优于治疗前及对照组，差异有统计学意义（P〈0．05）。与对照组相比，观察组患者有效率显著高于对照组，死亡率及再出血率显著低于对照组，差异有统计学意义（P〈0．05）。结论对高血胍脑出血患者应用锥颅血肿清除手术具有操作简单、省时、术中出血量少、安全可靠等优点，值得临床应用。

The clinical effect of skull hematoma clearance treatment of hypertensive cerebral hemorrhage PENG Changhai CHEN HaMming

Objective To diseuss the clinical effects of skull hematoma clearance in the treatment of 102 patients with hypertensive cerebral hemorrhage （HCH） and provide the clinical guidance for cerebral surgery. Methods Two hun dred and five patients with HCH admitted into our hospital from January 2008 to December 2012 were selected. According to their conditions and desires, they were divided into regular craniotomy group （control group, n=103） and skull hematoma clearance group （observation group, n=102）. The effects of operative treatment in both groups were comparatively analyzed. The glasgow coma scale （GCS） was applied to participants after surgery in order to observe the changes of GCS scores in the two groups before and after treatment. Results The operation time, intraoperatire blood loss, and average hospital stay in the observation groups were all superior to those in the control group with statistical differences （P 〈 0.05）. The postoperative GCS score in the observation group were remarkably better than that before treatment and in the control group, which displayed statistical differences （P 〈 0.05）. Compared with the control group, the effective rate in the observation group was greatly higher, while the mortality rate and recurrent bleeding rate were lower, with statistical differences （P 〈 0.05）. Conclusion In the treatment of HCH patients, application of skull hematoma clearance has some advantages of simple performance, timesaving, little intraoperative blood loss, safety, and reliability, which is worthy of extension in clinic.