细孔钻颅和小骨窗血肿清除术治疗老年高血压脑出血的疗效对比

目的 对比分析细孔钻颅术血肿抽吸术和小骨窗血肿清除术治疗老年高血压脑出血的疗效、安全性以及预后。方法 选择2014年1月至2015年1月亳州市人民医院收治的80例高血压脑出血患者，采用投掷硬币法将患者随机分为观察组40例及对照组40例，观察组行细孔钻颅血肿抽吸术，对照组行小骨窗血肿清除术，对比两组患者的手术效果、并发症、神经功能恢复情况及生存质量。结果 观察组手术时间、血肿吸收时间和住院时间均显著短于对照组（P<0.05），观察组血肿清除率、术后恢复率均高于对照组，差异有统计学意义（P<0.05），重残率、并发症均低于对照组（5.00% vs 45.00%，20.00% vs 27.50%），差异有统计学意义（P<0.05）；出院时、术后随访期间美国国立卫生研究院卒中量表（NIHSS）评分均显著低于对照组（P<0.05），观察组患者随访6个月、1年生存质量评分均高于对照组（P<0.05）。结论 细孔钻颅术较小骨窗血肿清除术治疗老年高血压脑出血疗效更为显著，并发症发生率低，术后恢复率高，且可明显改善患者神经功能和生存质量。

Comparison study of intracranial hematoma evacuation by small hole craniotomy versus small bone window approach in treatment of senile hypertensive cerebral hemorrhage

Objective To compare and analyze the efficacy, safety and prognosis of small hole craniotomy hematoma aspiration versus small bone window hematoma debridement in the treatment of senile hypertensive cerebral hemorrhage.Methods From Jan 2014 to Jan 2015, eighty patients with hypertensive cerebral hemorrhage ever treated in our hospital were selected and randomly divided by coin toss into the study group and the control group, 40 cases in each group. Patients in the study group received small hole craniotomy hematoma aspiration, while the control group were treated with small bone window hematoma debridement, and the postoperative efficacy, complications, neural function recovery, and quality of life between them were compared. Results The operation time, hematoma absorption time and hospitalization time in the study group were significantly shorter than those in the control group (P<0.05), and the hematoma clearance rate and postoperative recovery rate of the study group were also higher than those of the control group, with statistically significant differences (P<0.05). The incidence of severe disability and complications in the study group was more lower (5.00% vs 45.00%, 20.00% vs 27.50%), and the differences between the two groups were significant (P<0.05). The NIHSS score decreased gradually at hospital discharge and during the follow-up period with neural function recovery, but the study group always got significantly lower scores than the control group (P<0.05), and the scores of quality of life after 6 months of following up were significantly higher in the study group as well (P<0.05). Conclusion In the treatment of senile hypertensive cerebral hemorrhage, small hole craniotomy hematoma aspiration has an advantage of more significant efficacy, lower rate of complications, higher recovery rate than small bone window hematoma debridement, and could improve patients'' neural function and quality of life significantly.