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目的:探讨小骨窗开颅血肿清除术与大骨瓣开颅血肿清除术治疗高血压脑出血的疗效。方法:选取120例高血压脑出血患者,分为两组,对照组(60例)给予大骨瓣开颅血肿清除术,观察组(60例)给予小骨窗开颅血肿清除术。观察并记录患者围手术期指标,术前术后6个月神经功能缺损情况,术后6个月生活能力及随访12个月期间并发症、死亡例数情况,对比两种手术方法治疗高血压脑出血的疗效。结果:经小骨窗开颅血肿清除术治疗,观察组患者手术时间,术中输血量,住院时间均明显短于或少于采用大骨瓣开颅术治疗的对照组患者(P<0.05),但两组患者在血肿清除率上相比,差异没有统计学意义(P>0.05)。术前两组NIHSS评分相比,差异没有统计学意义(P>0.05)。术后6个月,两组NIHSS评分均明显降低,且观察组分值更低(P<0.05),术后6个月,观察组ADL评分为17.24±3.52,对照组ADL评分为22.73±5.67,观察组ADL评分明显低于对照组(P<0.05)。随访期间,两组死亡率相比较,差异没有统计学意义(P>0.05);并发症发生率方面相比较,观察组更低(P<0.05)。结论:小骨窗开颅血肿清除术对高血压脑出血具有较好的治疗效果,手术创伤小,神经功能影响小,能提高患者生活能力,术后并发症较少,值得临床推广使用。
Objective: To investigate the curative effect of small bone window craniotomy hematoma and large craniotomy hematoma in the treatment of hypertensive intracerebral hemorrhage. Methods: One hundred and twenty patients with hypertensive intracerebral hemorrhage were selected and divided into two groups. The control group (60 cases) was given craniectomy with large flap and the observation group (60 cases) was given craniotomy. Observed and recorded perioperative indicators, 6 months before and after surgery, neurological deficit, 6 months after surgery and 12-month follow-up complications, the number of deaths, compared with two surgical treatment of hypertension Efficacy of cerebral hemorrhage. Results: The operation time, intraoperative blood transfusion and hospitalization time in the observation group were significantly shorter or shorter than those in the control group (P <0.05) However, there was no significant difference in hematoma clearance between the two groups (P> 0.05). There was no significant difference in NIHSS score between the two groups before operation (P> 0.05). At 6 months after operation, the NIHSS scores of both groups were significantly lower and the values of the observed components were lower (P <0.05). After 6 months, the ADL score of the observation group was 17.24 ± 3.52 and the ADL score of the control group was 22.73 ± 5.67 , ADL score in observation group was significantly lower than that in control group (P <0.05). There was no significant difference in mortality between the two groups during follow-up (P> 0.05). The incidence of complications was lower in the observation group (P <0.05). Conclusion: Small craniotomy craniotomy removal of hypertensive intracerebral hemorrhage has a good therapeutic effect, small trauma, neurological function is small, can improve the living ability of patients with less postoperative complications, it is worth promoting the use of the clinic.