目的 观察微创穿刺引流术与小骨窗血肿清除术治疗高血压脑出血的临床效果,分析术后再出血的危险因素.方法 选取我院2014年3月—2016年11月收治的96例高血压脑出血,依据手术方式分为观察组和对照组,每组各48例.观察组予微创穿刺引流术,对照组予小骨窗血肿清除术,比较两组近期临床疗效,分析术后再出血的影响因素.结果 观察组、对照组的临床有效率分别为95.83％、93.75％,比较差异无统计学意义(χ2=0.21,P=0.65).多因素Logistic回归分析显示,术前收缩压、术后收缩压、发病至手术时间是影响高血压脑出血术后再出血的独立危险因素.结论 微创穿刺引流术与小骨窗血肿清除术治疗高血压脑出血临床疗效均较好,关注术后再出血的危险因素,可有效提高术后生存质量.%Objective To observe the clinical effects of minimally invasive puncture and drainage combined with small bone window craniotomy for removal of hematoma in the treatment of hypertensive intracerebral hemorrhage ( ICH) and the risk factors of postoperative rebleeding. Methods A total of 96 cases with hypertensive ICH admit-ted to our hospital from March 2014 to November 2016 were selected and randomly divided into observation group (n=48) and control group (n=48) according to different surgical methods. The patients in observation group were treated by minimally invasive puncture and drainage, whereas those in control group were treated by small bone win-dow craniotomy for removal of hematoma. The short-term clinical effects of the two groups were compared, and the in-fluencing factors of postoperative rebleeding were analyzed. Results The clinical effective rates of the observation group and the control group were 95.83％ and 93.75％, respectively, and the difference was not statistically signifi-cant (χ2 =0 .21 , P=0 .65 ) . Multiple factor logistic regression analysis showed that preoperative and postoperative systolic blood pressure, and duration between onset to operation were independent risk factors for postoperative re-bleeding in hypertensive ICH patients. Conclusion Minimally invasive puncture and drainage combined with small bone window craniotomy for removal of hematoma is effective in the treatment of hypertensive ICH. Therefore, medi-cal professionals should pay attention to risk factors for postoperative bleeding, which can effectively improve the sur-vival quality of the patients after operation.
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