不同术式治疗高血压脑出血的疗效分析

Clinical investigation of surgical treatments in hypertensive intracranial hemorrhage

关键词:  高血压脑出血  小骨窗开颅  骨瓣开颅  血肿碎吸术

Key words:  hypertensive intracranial hemorrhage  mall bone window penetration  raniotomy  surgery crashing and aspirating hematoma

摘要:

［目的］比较骨瓣开颅、小骨窗开颅、血肿碎吸术治疗高血压脑出血的临床疗效。［方法］分别选择GCS 8～12 分80例和GCS 5～7 分70 例高血压性基底节区脑出血病例，分为骨瓣组、小骨窗组、血肿碎吸组行显微手术治疗。［结果］GCS 8～12 分80例中：骨瓣组28 例，小骨窗组27 例，血肿碎吸组25 例。血肿碎吸组在手术疗效、预后等方面优于骨瓣组和小骨窗组，差异有显著性意义（P 均<0.05）。GCS 5～7 分70 例中：骨瓣组24 例，小骨窗组23 例，血肿碎吸组23 例，骨瓣组在手术疗效、预后等方面优于小骨窗组和血肿碎吸组，差异有显著性意义（P 均<0.05）。［结论］对于病情较轻者（GCS 8～12 分），血肿碎吸术优于小骨窗开颅和骨瓣开颅。对于病情较重者（GCS 5～7 分），骨瓣开颅优于小骨窗开颅和血肿碎吸术。

Abstract:

［Objective］ This is a clinical study to explore the curative effects of craniotomy, small bone window penetration (SBWP) and surgery crashing and aspirating hematoma (SCAH) in the treatment of hypertensive intracranial hemorrhage (HCH). ［Methods］ Eighty basal ganglion HCH patients with GCS score 8 to 12 and 70 basal ganglion HCH patients with GCS score 5 to 7 were divided into craniotomy group, SBWP group and SCAH group from June of 2003 to June of 2008. They were performed with respective surgical operation. ［Results］ In the 80 cases of GCS score 8 to 12, 28 of them were in craniotomy group; 27 were in SBWP group and 25 were in SCAH group. Curative effect and prognosis in SCAH were better than those in craniotomy and SBWP groups (P<0.05). In the 70 patients of GCS score 5 to 7, 24 cases were in craniotomy group, 23 were in SBWP group and 23 were in SCAH group. Craniotomy group had remarkable difference in curative effect and prognosis (P< 0.05) if compared to SBWP and SCAH groups. ［Conclusion］ Generally, if patient's condition is not serious (GCS score 8 to 12), SCAH is superior to SBWP and craniotomy. If patient's condition is serious (GCS score 5 to 7), craniotomy is greater than SBWP and SCAH.