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目的 :探讨微创颅内血肿清除术在高血压脑出血治疗中的优越性。方法 :保守组 38例行内科综合治疗 ,开颅组 38例在保守组治疗的基础上开骨瓣或骨窗 ,清除血肿 ,微创组 36例在保守组治疗的基础上行CT片定位法微创颅内血肿清除术 ,比较三组治疗的有效率、死亡率和治疗前、后神经功能缺损评分 ,采用t和 χ2 检验比较。结果 :保守组有效率 4 2 .1% ,死亡率 2 1.1% ,开颅组有效率为 5 5 .3% ,死亡率为 10 .5 % ,微创组有效率为 91.7% ,死亡率 2 .8% ,微创组与开颅组和保守组比较均有显著性差异 (P <0 .0 5 ) ;微创组于治疗后第 1天神经功能缺损评分即见明显减少 ,而开颅组和保守组均于治疗后第 14天才有明显减少 ,微创组与开颅组和保守组比较均有显著性差异 (P <0 .0 5 )。结论 :微创颅内血肿清除术在高血压脑出血治疗中能提高有效率、降低死亡率、加快神经功能恢复。
Objective: To investigate the superiority of minimally invasive intracranial hematoma in the treatment of hypertensive intracerebral hemorrhage. Methods: In the conservative group, 38 cases were treated by internal medicine. In the craniotomy group, 38 cases were treated with conservative treatment. On the basis of conservative treatment, the bony flap or the bone window was removed and the hematoma was cleared. Thirty-six cases in the minimally invasive group were treated with conservative treatment. Create intracranial hematoma, compared the three groups of treatment efficiency, mortality and neurological deficit score before and after treatment, using t and χ2 test comparison. Results: In the conservative group, the effective rate was 42.1%, the mortality rate was 1.1%, the effective rate in the craniotomy group was 55.3%, the mortality rate was 10.5%, the minimally invasive group was 91.7% and the mortality rate was 2 .8%. There was significant difference between minimally invasive group and craniotomy group and conservative group (P <0.05). In the minimally invasive group, the score of neurological deficit was significantly decreased on the first day after treatment, There was a significant difference between the minimally invasive group and the craniotomy group and the conservative group on the 14th day after treatment (P <0.05). Conclusion: Minimally invasive intracranial hematoma can improve the efficiency, reduce the mortality and accelerate the recovery of neurological function in the treatment of hypertensive intracerebral hemorrhage.