不同外科治疗方法治疗高血压脑出血疗效比较探究.doc

不同外科治疗方法治疗高血压脑出血疗效比较探究[摘要] 目的 探讨应用不同外科治疗方法治疗高血压脑出血的疗效，从而为高血压脑出血的外科治疗如何合理选择手术方式和手术时机提供进一步的参考依据。方法 将2008年1月～2010年1月在我院及浙江省人民医院神经外科住院进行手术治疗的68例高血压脑出血患者作为观察对象，其中36例应用小骨窗开颅术，设立为观察组，32例应用传统大骨瓣开颅术，设立为对照组，回顾性分析68例高血压脑出血患者的临床资料，应用统计学方法从以下方面进行对比研究：术后两组的ADL分级疗效情况、治疗后不同时间两组神经功能缺损评分变化情况、两组术后并发症发生率情况、两组术后血肿清除率及死亡率情况。结果 ①与对照组比较，观察组的Ⅰ～Ⅲ级别的恢复良好率为83.3%（30/36），明显高于对照组62.5%（20/32）（P＜0.05）。②两组治疗后2周及4周的神经功能缺损评分均较治疗前明显改善，且观察组较对照组改善更明显（P＜0.05）。③两组并发症发生率比较，差异无统计学意义（P＞0.05）。④术后两组的血肿清除率比较差异不显著，但观察组术后死亡率明显低于对照组（P＜0.05）。结论 小骨窗开颅术与大骨瓣开颅术各具优缺点，临床医生需根据适应证选择合理的手术方式进行手术。 [关键词] 高血压脑出血；小骨窗开颅术；传统大骨瓣开颅术；ADL分级；并发症 [中图分类号] R651.1+2；R743.34 [文献标识码] B [文章编号] 1673-9701（2011）31-39-03 Comparative Study on Different Methods of Surgical Treatment of Hypertensive Cerebral Hemorrhage WU Yunlong TCM Hospital of Xianju County in Zhejiang Province, Xianju 317300, China [Abstract] Objective To evaluate different surgical methods treatment hypertensive cerebral hemorrhage, which is the surgical treatment of hypertensive cerebral hemorrhage on how a reasonable choice of surgical approach and timing of surgery for further reference. Methods There were 68 patients with hypertensive cerebral hemorrhage as the object of observation from January 2008 to January 2010 in our hospital, 36 patients were treated with a small bone window craniotomy, the establishment of the observation group, 32 patients were treated with traditional large trauma craniotomy, the establishment of the control group, retrospective analysis of 68 cases of hypertensive cerebral hemorrhage clinical data, the application of statistical methods were compared from the following aspects: ①The ADL classification after two treatment conditions；②Two different times after treatment of neurological deficit score changes; ③The incidence of postoperative complications；④Postoperative hematoma rate and mortality rates. Results ①With the control group to observe the groupⅠ-Ⅲ level of good recovery rate was 83.3% (30/36), significantly higher than 62