赵文卿　赵俊

[摘要] 目的 探讨微创穿刺术与小骨窗开颅术治疗高血压脑出血的疗效。方法 选取2015年1月～2016年1月我院治疗的高血压脑出血患者60例作为研究对象，其中30例采用微创穿刺术（微创组），30例采用小骨窗开颅术（对照组），比较两组患者治疗后的临床疗效，以及两组患者治疗前后SSS评分、MRS评分的变化情况，并对两组患者的术后并发症发生率进行对比分析。 结果 治疗后，微创组的总有效率90.00%，显著高于对照组的70.00%（P<0.05）。微创组患者的SSS评分术后显著低于对照组、MRS评分术后显著低于对照组（P<0.05）。微创组的并发症发生率10.00%，显著低于对照组的33.33%（P<0.05）。 结论 微创穿刺术与小骨窗开颅术治疗高血压脑出血均取得了较好的疗效，但微创穿刺术患者术后恢复快、并发症少、能明显改善患者的神经功能，预后更好。

[关键词] 高血压脑出血；微创穿刺术；小骨窗开颅术；并发症

[中图分类号] R719.8 [文献标识码] B [文章编号] 1673-9701（2017）16-0042-03

[Abstract] Objective To investigate and compare the therapeutic effect of minimally invasive puncture and small bone window craniotomy for hypertensive cerebral hemorrhage. Methods 60 patients were selected in our hospital from January 2015 to January 2016， 30 cases of hypertensive cerebral hemorrhage were treated with minimally invasive surgery （minimally invasive group）， 30 cases were treated with small bone window craniotomy（control group）， the clinical efficacy of two groups were compared after treatment， and the changes of SSS score and MRS score before and after treatment were observed in the two groups， and the postoperative complications in the two groups were compared and analyzed. Results After treatment， the total effective rate of the minimally invasive group was 90.00%， which was significantly higher than that of the control group（70.00%）（P<0.05）. After the operation，the SSS score in minimally invasive group was significantly lower than the control group， the scores of MRS were significantly lower than the control group（P<0.05）. The complication rate of the minimally invasive group was 10.00%， significantly lower than that of the control group（33.33%）（P<0.05）. Conclusion Minimally invasive puncture and small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage have achieved good curative effect， but patients with minimally invasive puncture and rapid postoperative recovery， less complications and improve the neurological function of patients with a better prognosis.

[Key words] Hypertensive intracerebral hemorrhage； Minimally invasive puncture； Small bone window craniotomy； Complications

高血壓脑出血（hypertensive intracerebral he morrhage，ICH）是神经外科的常见病、多发病，病死率和致残率较高。内科保守治疗效果差，而外科手术是治疗高血压脑出血的最佳选择，具有能有效解除血肿压迫，控制脑水肿，防止再出血发生的作用[1]。但外科开颅手术创伤大、术后后遗症严重，致死率高。近年来随着微创技术的不断发展，微创穿刺术目前已经广泛应用于高血压脑出血的治疗，并取得了较好的治疗效果[2-3]，本研究旨在探讨微创穿刺术治疗高血压脑出血的疗效，并与小骨窗开颅术的疗效进行比较，现报道如下。

1 资料与方法

1.1 一般资料

选择我院2015年1月～2016年1月期间收治的高血压脑出血患者60例作为研究对象，其中30例采用微创穿刺术，30例采用小骨窗开颅术。微创组30例患者中，男17例、女13例，年龄41～65岁，平均（53.2±11.5）岁，出血量>50 mL 18例；对照组30例患者中，男16例、女14例，年龄42～64岁，平均（54.6±12.8）岁，出血量>50 mL 16例；两组患者的性别、年龄等一般资料比较差异无统计学意义（P>0.05），具有可比性。……