摘要
目的比较大骨瓣开颅血肿清除术、小骨窗开颅血肿清除术、钻孔血肿抽吸引流术治疗高血压脑出血的临床效果。方法选择2014年5月—2018年5月该院神经外科200例高血压脑出血患者,根据手术方式分为A组(大骨瓣开颅血肿清除术,53例)、B组(小骨窗开颅血肿清除术,68例)、C组(钻孔血肿抽吸引流术,79例),比较颅内血肿完全清除率、手术情况、术后并发症发生率、颅内压。结果A组、B组、C组的颅内血肿完全清除率分别为96.23%、97.06%、92.41%,组间比较差异无统计学意义(χ2=1.895,P>0.05);B组、C组的手术用时分别为(64.75±10.76)min、(66.19±10.53)min,均短于A组(85.43±17.64)min(t=7.958、7.841,P<0.05);B组、C组的术中出血量分别为(40.47±12.69)mL、(38.97±13.45)mL,均少于A组(96.85±27.54)mL(t=14.977、16.061,P<0.05);B组、C组的术后并发症总发生率分别为2.94%、2.53%,均低于A组(χ2=5.806、7.150,P<0.05);治疗后,B组、C组的颅内压分别为(13.49±2.01)mmHg、(13.31±1.98)mmHg,均低于A组(t=6.800、7.586,P<0.05)。结论相比于大骨瓣开颅血肿清除术,小骨窗开颅血肿清除术、钻血肿抽吸引流术用于高血压脑出血患者中均更具有优势,可有效减轻手术创伤,减少术后并发症。
Objective To compare the clinical effects of large bone flap craniotomy hematoma removal,small bone window craniotomy hematoma removal,and drilling hematoma aspiration flow for the treatment of hypertensive cerebral hemorrhage.Methods From May 2014 to May 2018,200 patients with hypertensive cerebral hemorrhage in the department of neurosurgery were selected and divided into group A(large bone flap craniotomy for hematoma removal,53 cases)and group B(small bone window opening cranial hematoma removal,68 cases)and group C(borehole hematoma aspiration and drainage,79 cases)according to the surgical method,compared for complete removal rate of intracranial hematoma,surgical situation,incidence of postoperative complications,and intracranial pressure.Results The complete clearance rates of intracranial hematomas in group A,group B,and group C were 96.23%,97.06%,and 92.41%,respectively.There was no statistical difference between the groups(χ2=1.895,P>0.05).The operating time was(64.75±10.76)min and(66.19±10.53)min,respectively,which were shorter than those in group A(85.43±17.64)min(t=7.958,7.841,P<0.05);the intraoperative blood loss in groups B and C were(40.47±12.69)mL and(38.97±13.45)mL were less than those in group A(96.85±27.54)mL(t=14.977,16.061,P<0.05);the total incidence of postoperative complications in groups B and C were 2.94%and 2.53%,both lower than group A(χ2=5.806,7.150,P<0.05);after treatment,the intracranial pressures of group B and group C were(13.49±2.01)mmHg and(13.31±1.98)mmHg,which were lower than those of group A(t=6.800,7.586,P<0.05).Conclusion Compared with large bone flap craniotomy hematoma removal,small bone window craniotomy hematoma removal and drill hematoma suction suction are more advantageous for patients with hypertensive cerebral hemorrhage,which can effectively reduce surgical trauma and reduce postoperative complications.disease.
作者
曹忠文
孙霄
刘景传
CAO Zhong-wen;SUN Xiao;LIU Jing-chuan(Heze Mudan People's Hospital,Heze,Shandong Province,274000 China;Heze Municipal Hospital,Heze,Shandong Province,274000 China)
出处
《系统医学》
2020年第2期74-76,共3页
Systems Medicine
关键词
神经外科
高血压脑出血
大骨瓣开颅血肿清除术
小骨窗开颅血肿清除术
钻孔血肿抽吸引流术
Neurosurgery
Hypertensive cerebral hemorrhage
Large bone flap craniotomy hematoma removal
Small bone window craniotomy hematoma removal
Drilling hematoma aspiration flow
