小骨窗开颅与常规骨瓣开颅治疗高血压脑出血的疗效分析

　　[摘要] 目的 探讨小骨窗开颅与常规骨瓣开颅治疗高血压脑出血的临床效果。方法 方便选取2012年5月—2016年5月来该院治疗高血压脑出血患者117例，并将患者按随机原则分为2组。所有患者经CT扫描为幕上出血。对照组（58例）患者行常规骨瓣开颅手术治疗，实验组（59例）患者行小骨窗开颅手术治疗，对两组患者临床治疗效果及术后并发症发生情况进行比较。结果 经过比较发现，对照组治疗有效率为65.52%，实验组治疗有效率为79.66%，实验组患者治疗有效率显著高于对照组，差异有统计学意义（P<0.05）。另外，实验组术后并发症发生率为27.12%，对照组术后并发症发生率为41.38%。实验组患者长期昏迷和中残率低于对照组，差异有统计学意义（P<0.05）。 结论 小骨窗开颅术与常规骨瓣开颅术都是治疗高血压脑出血的常用术式，但小骨窗开颅术治疗高血压脑出血患者效果显著优于常规骨瓣开颅术，可在临床上推广应用。
　　[关键词] 小骨窗开颅术；常规骨瓣开颅；高血压脑出血
　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0110-03
　　[Abstract] Objective This paper tries to investigate the clinical effect of small bone window craniotomy and conventional craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods 117 patients with hypertensive intracerebral hemorrhage were convenient selected from May 2012 to May 2016 in this hospital， and the patients were divided into 2 groups according to the principle of randomization. All patients were supratentorial hemorrhage by CT scan. The control group underwent conventional craniotomy treatment， the experimental group were treated with small bone window craniotomy treatment， compared two groups of patients with clinical effect and postoperative complications. Results Through the comparison， the effective rate of the control group was 65.52%， the effective rate of the experimental group was 79.66% in the experimental group（59 cases） the effective rate of treatment was significantly higher than the control group （58 cases）， there was statistical significance（P<0.05）. In addition， the incidence of postoperative complications in the experimental group was 27.12%， and the incidence of postoperative complications in the control group was 41.38%. The long-term coma and residual rate in the experimental group were lower than those in the control group， with statistical significance （P<0.05）. Conclusion Small bone window craniotomy and routine craniotomy are commonly used in the treatment of hypertensive cerebral hemorrhage， but small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage patients is significantly better than conventional craniotomy， can be widely applied in clinical practice.
　　[Key words] Small bone window craniotomy； Routine bone flap craniotomy； Hypertensive cerebral hemorrhage
　　高血壓脑出血是临床上常见脑血管疾病，临床上致残率致死率都很高，是脑血管疾病中首位，对患者生命安全产生严重威胁[1]。高血压脑出血患者占卒中患者的20%左右，通常病情十分危急，存活者也多出现严重病残。在临床上治疗高血压脑出血多采用手术治疗，常用术式有小骨窗开颅术与常规骨瓣开颅术[2]。但针对其治疗效果临床上并不确定，为探讨2种术式治疗高血压脑出血的实际效果，该研究方便选取2012年5月—2016年5月来该院治疗高血压脑出血患者117例，并将患者按随机原则分为2组。现报道如下。