探讨小骨窗开颅血肿清除术与微创血肿穿刺清除术治疗脑出血临床疗效

崔来贤

[摘要] 目的 在腦出血中应用微创血肿穿刺清除术与小骨窗开颅血肿清除术治疗的临床影响效果探讨。 方法 方便选取该院于2016年7月—2017年7月收治的80例高血压脑出血患者按手术方式的不同进行分组：A组与B组，各40例。小骨窗开颅血肿清除术用于A组中，微创血肿穿刺清除术用于B组中，对2组患者的术后昏迷时间、血肿清除量和神经功能缺损评分状况以及并发症发生状况进行比较观察。 结果 A组的术后昏迷时间为（10.45±2.46）d，血肿清除量为（17.63±4.31）mL，神经功能缺损评分为（3.87±0.87）分；而B组的术后昏迷时间为（6.42±2.12）d，血肿清除量为（11.34±2.45）mL，神经功能缺损评分为（1.43±0.34）分；比较可知A组的术后昏迷时间长于B组，且血肿清除量低于B组，而B组的神经功能缺损评分状况显著优于A组（P<0.05）。在并发症方面，A组的并发症发生率为27.50%，高于B组的7.50%（P<0.05）。结论 微创血肿穿刺清除术治疗脑出血的疗效显著，能够有效提高总有效率，适合推广。

[关键词] 小骨窗开颅血肿清除术；微创血肿穿刺清除术；脑出血；临床疗效

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）05（a）-0089-03

Study on Clinical Curative Effect of Small Bone Window Craniotomy Evacuation of Hematoma and Minimally Invasive Hematoma Puncture Scavenging in Treatment of Cerebral Hemorrhage

CUI Lai-xian

Department of Neurosurgery， Zibo Central Hospital， Zibo， Shandong Province， 255036 China

[Abstract] Objective To study the clinical curative effect of small bone window craniotomy evacuation of hematoma and minimally invasive hematoma puncture scavenging in treatment of cerebral hemorrhage. Methods 80 cases of patients with hypertensive cerebral hemorrhage admitted and treated in our hospital from July 2016 to July 2017 were convenient selected and divided into two groups with 40 cases in each， the group A and the group B were respectively treated with small bone window craniotomy evacuation of hematoma and minimally invasive hematoma puncture scavenging， and the postoperative coma time， hematoma clearance， nerve function defect score and incidence rate of complications were compared between the two groups. Results The postoperative coma time in the group was longer than that in the group B，[（10.45±2.46）d vs （6.42±2.12） d]， and the hematoma clearance in the group A was lower than that in the group B， [（17.63±4.31）mL vs （11.34±2.45）mL]， and the nerve function defect score in the group A was obviously better than that in the group A[（3.87±0.87）marks vs（1.43±0.34） marks]（P<0.05）， and the incidence rate of complications in the group A was higher than that in the group B，（27.50% vs 7.50%）（P<0.05）. Conclusion The curative effect of minimally invasive hematoma puncture scavenging in treatment of cerebral hemorrhage is obvious， which can effectively improve the total effective rate， and it is suitable promotion.

[Key words] Small bone window craniotomy evacuation of hematoma； Minimally invasive hematoma puncture scavenging； Cerebral hemorrhage； Clinical curative effect

脑出血患者往往于過度劳累、情绪激动等情况下突然发病，若未能及时控制病情，其病死率和致残率极高，大部分幸存患者存在不同程度的言语、认知、运动障碍等后遗症[1]。当前，手术方法是脑出血的首选治疗手段，临床上比较常见的手术方法有微创血肿穿刺清除术、小骨窗开颅血肿清除术等，微创血肿穿刺清除术具有较为明显的操作简便、创伤性小等临床特征，该文针对80例于2016年7月—2017年7月收治的高血压脑出血患者采取以上两种手术方法展开治疗，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的80例高血压脑出血患者，按手术方式的不同进行分组：A组与B组，各40例。……