高血压脑出血手术治疗方案的探讨

摘要

目的：探究高血压脑出血不同外科治疗措施的临床效果。方法回顾性分析318例高血压脑出血外科治疗患者临床资料，其中64例行传统骨瓣开颅血肿清除术（A组），117例行CT引导定向血肿吸引术（B组），137例患者行锁孔开颅血肿清除术（C组），对其治疗效果、术后KPS评分以及Barthel评分进行对比分析。结果手术后1个月C组与A组病死率比较差异有统计学意义（P＜0.05），B组与C组病死率无统计学意义。手术后3个月，C组与A组病死率比较差异有统计学意义（P＜0.01），B组与A组病死率比较差异有统计学意义（P＜0.05），其中A组为28.13%，B组为21.37%，C组为16.79%；手术后1个月和3个月C组和B组KPS评分以及Barthel评分均高于A组（P＜0.05或P＜0.01）。结论与传统骨瓣开颅血肿清除术治疗措施相比较，CT引导定向血肿吸引术和锁孔开颅血肿清除术在降低患者病死率和改善愈合情况方面效果更为优良。%Objective To explore the clinical effect of different surgical treatment of hypertension cerebral hemorrhage. Methods A retrospective analysis of clinical data of 318 cases of hypertensive cerebral hemorrhage surgery patients, 64 of whom underwent traditional bone flap craniotomy for removal of hematoma (group A), 117 underwent CT guided directional hematoma aspiration (group B), 137 cases of patients with row locking hole craniotomy for removal of hematoma (group C), the operation method, therapeutic effect, postoperative KPS score and Barthel score were analyzed. Results 318 of 318 patients underwent traditional bone flap craniotomy hematoma removal treatment (group A), 117 underwent CT guided directional hematoma aspiration (group B) treatment, 137 cases of patients with row locking hole craniotomy hematoma removal treatment (group C), 1 month after the surgery treatment group C compared with group A disease mortality compared with the difference was statistically significant (P<0.05), treatment group B and group C disease mortality has no statistical significance. Three months after the surgery, treatment group C and group A case fatality rate has significant difference statistically significant meaning (P<0.01), treatment group B and group A case fatality rate comparison difference was statistically significant (P<0.05), in which the group A was 28.13%, group B was 21.37%, group C is 16.79%;1 month and 3 months after surgery in group C and group B treatment KPS score and Barthel score were higher than treatment group A (P<0.05 or P<0.01). Conclusion Compared with traditional bone flap craniotomy hematoma removal treatment compared with CT guided directional hematoma aspiration and lock hole craniotomy for removal of hematoma in patients with lower disease mortality and has a strong effect more improve healing situation.