小骨窗开颅血肿清除治疗高血压脑出血的临床效果.docVIP

小骨窗开颅血肿清除治疗高血压脑出血的临床效果 　　[摘要] 目的 探讨小骨窗开颅血肿清除手术治疗高血压脑出血的临床疗效。 方法 将2009年1月～2012年12月本院收治并行手术治疗的84例高血压脑出血患者随机分为大骨瓣开颅组（42例）和小骨窗开颅组（42例）。对两组患者的近远期疗效、血肿清除率、再出血情况等进行比较。 结果 术后21 d患者生活能力评定（按ADL分级），小骨窗组明显优于大骨瓣组（P0.05）；术后小骨窗组残留血肿量为（9±1） ml，明显少于大骨瓣开颅组的（15±3） ml（P0.05）；术后12 h小骨窗组有2例（4.76%）再出血，大骨瓣组有8例（19.05%）发生再出血，两组再出血率差异有统计学意义（P0.05）。 结论 小骨窗开颅血肿清除术能提高高血压脑出血患者的疗效，降低再出血率。 　　[关键词] 高血压脑出血；小骨窗；治疗 　　[中图分类号] R651.1+2[文献标识码] A[文章编号] 1674-4721（2014）06（a）-0042-03 　　 　　Clinical experience on hematoma removal by means of craniotomy with small bone window resection in the treatment of hypertensive intracranial hematoma 　　FENG Yu-xiu CHEN Zhi-guo GAO Zhen-jun 　　Brain Center of People′s Hospital of Guangning County in Guangdong Province,Guangning 526300,China 　　[Abstract] Objective To explore the clinical efficacy of small bone window craniotomy in the treatment of hypertensive intracranial hematoma. Methods A total of 84 cases of patients with hypertensive intracranial hematoma were enrolled in this study from January 2009 to December 2012 and were divided into large trauma craniotomy group (42 cases) and small bone window craniotomy group (42 cases),were treated with large trauma craniotomy and small bone window craniotomy,respectively. Average expense,average hospitalization time,the rate of complications and short-term and long-term effects,hematoma clearance,rebleeding rate were compared. Results The patients’ viability (ADL classification) 21 days after operation was higher in small bone window craniotomy group compared with large trauma craniotomy group (P0.05).The residual hematoma was (9±1) ml in small bone window craniotomy group,while the residual hematoma was (15±3) ml in large trauma craniotomy group,the difference was significant (P0.05).2 cases (4.76%) in small bone window craniotomy group and 8 cases (19.05%) in large trauma craniotomy grouphad the incident of rebleeding,the difference of two groups was significant (P0.05). Conclusion Small bone window craniotomy is