目的 探讨小骨窗开颅显微术和微创颅内血肿消除术治疗高血压脑出血的临床疗效.方法 将118例高血压脑出血患者随机分为小骨窗开颅显微术(对照组)和微创颅内血肿消除术(观察组),每组各59例,对两组手术时间、术中出血、术后神经功能改善情况、日常生活活动能力恢复情况等进行比较.结果 观察组优良率为57.63%,死亡率为6.78%;对照组优良率为44.07%,死亡率为10.17%,两组比较差异有统计学意义(P<0.05).观察组手术时间(1.02±0.37)h,术中出血(48.51±5.08)ml,住院时间(10.08±1.65)d,对照组手术时间(2.79±1.08)h,术中出血(187.23±11.87 ml,住院时间(21.39±4.68)d,两组比较,差异有显著性(P<0.05 ).观察组术后神经功能恢复及ADL能力恢复方面也优于对照组(P<0.05).结论 微创颅内血肿清除术的手术时间及住院时间短,术中出血少,术后神经功能及ADL能力恢复均优于小骨窗开颅显微术,值得临床大力推广应用.%Objective To explore the efficacy of small skull-window craniotomy versus that of minimally invasive evacuation of intracranial hematoma for hypertensive intracerebral hemorrhage. Methods 118 patients with hypertension-induced cerebral hemorrhage were randomly assigned to receive small skull-window craniotomy ( 59 patients, control group ), or minimally invasive evacuation of intracranial hematoma ( 59 patients, study group ). The surgical duration, intraoperative bleeding volume, length of hosptial stay, postoperative recovery of nerve function, and activities of daily living were compared between the two groups. Results The surgical duration, bleeding volume, length of hospital stay, nerve recovery of nerve function, and activities of daily living were better in the study group than in the control group ( P < 0.05 ). Conclusions Minimally invasive evacuation of intracranial hematoma has shorter surgical duration and length of hospital stay and has less intraoperative bleeding. It is superior to small skull-window craniotomy in the recovery of nerve function and activities of daily living. It is worth popularizing.
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