小骨窗开颅显微手术治疗高血压基底节区脑出血临床分析

目的探讨小骨窗开颅显微手术治疗高血压基底节区脑出血的临床疗效。方法收集84例高血压基底节区脑出血患者的临床资料,按手术方式不同分为小骨窗开颅显微手术组(观察组)和传统大骨瓣开颅手术组(对照组)各42例,2组术后均给予规范化综合治疗,比较2组术后并发症及术后3个月ADL评分、再出血率及平均住院时间等。结果观察组和对照组术后并发症的发生率分别为11.90%和30.95%,2组比较差异有统计学意义(P<0.05);观察组术后ADL评分明显显著优于对照组(P<0.05);2组术后血肿复发率、病死率及血肿清除率比较差异均无统计学意义(P>0.05)。结论与传统大骨瓣开颅手术比较,小骨窗显微手术治疗高血压基底节区脑出血具有创伤小、术后神经功能恢复好、并发症少及住院时间短等优点,值得临床推广应用。

Small bone flap craniotomy in the treatment of hypertensive hemorrhage in basal ganglia region

Objective To explore the effectiveness of small bone flap craniotomy in the treatment of hypertensive hemorrhage of basal ganglia region.Methods Clinical data of 84 patients with hypertensive hemorrhage of basal ganglia region were collected,and were divided into small bone flap craniotomy group(observation group) and large bone flap craniotomy group(control group),each group with 42 patients.All the patients received the same standardized comprehensive treatment after surgery,the rebleeding rate,complication rate,average stay and 3 months of the ADL score of the two groups were compared.Results The complication rate of observation group and control group was 11.90% and 30.95%,respectively,there was statistically significant difference(P<0.05).The ADL score of observation group was better than control group(P<0.05),there were no statistically significant differences between the two groups in rebleeding rate,mortality and hematoma rate(P>0.05).Conclusion Compared to large bone flap craniotomy,small bone flap craniotomy has advantage of smaller invasive,fewer postoperative complication and shorter hospitalization time,and it is worth to popularizing in clinic.