微创手术治疗高血压脑出血的疗效分析

目的：探讨微创手术治疗高血压脑出血的疗效和预后,并与传统大骨瓣开颅术的疗效和预后进行比较.方法：2007年7月-2010年7月90例高血压脑出血患者,其中行大骨瓣开颅术30例、锥颅引流术30例、小骨窗开颅血肿清除术30例,比较3组患者平均住院费用、平均住院天数、并发症发生率及近期疗效等指标.结果：锥颅引流组、小骨窗开颅组患者的平均住院费用、平均住院天数、并发症发生率均小于大骨瓣开颅组,差异均有统计学意义（P＜0.05）.按照Glasgow预后评分（GOS）对患者进行预后评估,小骨窗开颅组、锥颅引流组、大骨瓣开颅组愈后良好率分别为46.7％、43.3％、26.7％,其中小骨窗开颅组和锥颅引流组的愈后良好率均优于大骨瓣开颅组,差异均有统计学意义（P＜0.05）;而小骨窗开颅组和锥颅引流组的平均住院费用、平均住院天数、并发症发生率、愈后良好率比较差异无统计学意义（P＞0.05）.结论：锥颅引流术、小骨窗开颅血肿清除术治疗高血压脑出血均优于大骨瓣开颅,而锥颅引流术与小骨窗开颅血肿清除术无明显差异.

Therapeutic Effect of Minimally Invasive Surgeries on Hypertensive Cerebral Hemorrhage

Objective：To explore the efficacy of minimally invasive surgeries （MIS） in hypertensive cerebral hemorrhage （HCH）.Methods：A total of 90 patients with HCH were enrolled in this study from July 2007 to July 2010.Among them,30 patients were treated with large trauma craniotomy,30 patients were treated with drilling skull drainage,and 30 patients were treated with small bone window craniotomy.Average expense,average hospitalization time,the rate of complications and shortterm effects were studied.Results：The average expense was higher,the average hospitalization time was longer and the complication rate was higher in large trauma craniotomy group compare with small bone window craniotomy group and drilling skull drainage group（P＜0.05）.The prognosis of patients was evaluated with Glasgow outcome scale（GOS）,and the good prognosis rates of small bone window craniotomy group,drilling skull drainage group and large trauma craniotomy group were 46.7％,43.3％ and 26.7％,respectively.The good prognosis rates in small bone window craniotomy group and drilling skull drainage group were significantly higher than that in large trauma craniotomy group（P＜0.05）.However,there were no differences in average expense,average hospitalization time,complication rate and short-term effects between small bone window craniotomy group and drilling skull drainage group（P＞0.05）.Conclusions：Small bone window craniotomy and drilling skull drainage are better than large trauma craniotomy in the treatment of HCH,but there is no difference between small bone window craniotomy and drilling skull drainage.