微创小骨窗开颅术治疗高血压脑出血的临床观察

目的探讨小骨窗手术治疗高血压脑出血的临床效果及其意义。方法选取2005年1月至2010年10月在我院住院治疗的高血压脑出血患者56例,随机分为治疗组36例和对照组20例;治疗组接受微创小骨窗开颅血肿清除术,对照组接受传统大骨瓣开颅血肿清除术,根据出血量、发病时间、发病年龄、血肿部位、GCS评分等进行回顾性分析,追踪随访临床效果。结果治疗组死亡4例,病死率11.1%,明显低于对照组,且差异具有统计学意义(P0.05)。按照ADL标准评定预后,存活病例6个月后随访,I级8例,II级12例,III级7例。IV级4例,V级1例。明显优于对照组,且差异具有统计学意义(P0.05)。结论微创小骨窗清除术早期施行疗效明显优于传统开颅术,是高血压性脑出血较理想的术式,值得基层医院临床推广应用。

Therapeutic effect of small bone window craniotomy in treatment of hypertensive cerebral hemorrhage

Objective To investigate the results of applying mini-craniotomy in treating hypertensive cerebral hemorrhage.Methods Fifty-six cases with hypertensive intracerebral hemorrhage from January 2005 to October 2010 were divided into the treatment group(n=36) and control group(n=20).The treatment group received the key-hole surgery while the control group received the large trauma craniotomy.All of the patients were followed-up.Results Among the 36 cases,4 were dead and the mortality rate was 11.1%.They were fewer than those in control group,and there were significant differences between the two groups(P<0.05).According to ADL standards to assess the prognosis,32 patients were followed up after 6 months of survival.The ratings were as follows:Grade I:8 cases;Grade II:12 cases;Grade III:7 cases;Grade IV:4 cases;Grade V:1 case;These were better than those in control group,and there were significant differences between the two groups(P<0.05).Conclusion The key-hole surgery is superior to the traditional operation,and is the ideal operation for patients with hypertensive intracerebral hemorrhage,which is worth being used widely.