袁文生



小骨窗开颅显微镜下血肿清除术在高血压脑出血患者中的疗效探讨

袁文生

【摘要】目的 探讨小骨窗开颅显微镜下血肿清除术在高血压脑出血中的疗效。方法 选择我院高血压脑出血患者120例作为观察对象。根据手术方式分成观察组与对照组，每组60例。对照组患者采用大骨瓣开颅术，观察组进行小骨窗开颅显微镜下血肿清除术。比较两组平均手术时间、住院时间及并发症。结果 观察组在住院时间、平均手术时间及术后并发症发生率等方面优于对照组，差异有统计学意义（P＜0．05）。结论 小骨窗开颅显微镜下血肿清除术较大骨瓣开颅术，手术时间少，治疗过程短，并发症少。

【关键词】大骨瓣开颅术；小骨窗开颅；血肿清除术

Objective To discuss the efficacy of small bone window craniotomy of hematoma under microscope in hypertensive cerebral hemorrhage patients．Methods 120 cases of hypertensive cerebral hemorrhage in our hospital were selected as the observation objects． According to the operation mode，were divided into two groups the observation group and the control group，60 cases in each group． The control group were treated by craniotomy，the observation group were under the microscope craniotomy with evacuation of hematoma． The average operation time，hospital stay and complications were compared between the two groups． Results Compared with the control group，the observation group was superior to the control group in terms of length of stay，average operation time and postoperative complication rate，and the difference was statistically significant（P＜0．05）． Conclusion Under microscope small bone window craniotomy hematoma，has less operative time，shorter course of treatment and fewer complications．

【Key words】 Large trauma craniotomy，Small bone window craniotomy，Hematoma

高血压脑出血为临床常见的脑血管危重疾病之一，发病迅速，抢救不及时极易造成患者死亡。目前临床治疗高血压脑出血的首要目的是降低颅内压、清除血肿、避免脑疝发生及脑组织的继发性损害［1］。高血压脑出血的主要临床手术方法包括小骨窗开颅术、大骨瓣开颅术、微创穿刺吸除术以及内镜清除术等［2］。本研究旨在比较小骨窗开颅与大骨瓣开颅两种方法的临床疗效。现将研究结果报告如下。

1 资料与方法

1.1 一般资料

选择高血压脑出血患者120例作为研究对象，均于2013年11月～2016年1月来我院接受治疗。根据采取的手术方式分成观察组（60例）与对照组（60）例。观察组男39例，女21例，年龄32～78岁，平均（56.7±2.6）岁；对照组男36例，女24例年龄34～77岁，平均（55.8±1.8）岁。经头颅CT判断，两组患者无单、双侧瞳孔散大或中线移位明显等情况，血肿均未累及脑干。……