【摘要】 目的 比较小骨窗与常规颞顶瓣开颅术治疗高血压脑出血的效果。方法 符合标准的高血压脑出血病人113例，分为2组，其中小骨窗组57例，常规骨瓣组56例。所有病人均经CT扫描为幕上出血。小骨窗治疗组根据血肿部位采用小骨窗开颅术(3 cm×3 cm)。常规骨瓣组根据血肿部位采用颞顶瓣或额颞瓣开颅减压方法( 6 cm×8 cm)。结果 小骨窗开颅治疗组病人恢复良好率明显高于常规骨瓣组，长期昏迷和中残率低于常规骨瓣组(P<0.05)，小骨窗治疗组患者术后脑水肿和切口脑脊液漏发生率均低于常规骨瓣组(P<0.05)。结论 小骨窗开颅术治疗高血压脑出血病人的疗效明显好于常规颞顶瓣开颅术。
【关键词】 小骨窗;常规骨瓣;高血压脑出血
Analysis of hypertensive intracerebral hemorrhage treated by small window craniotomy and routine craniotomy Zhang Xianbai, Yuan Zhifu, Dong Ming. The People’s Hospital of Wuning County, Wuning 332300, China
【Abstract】 Objective To compare the effect of small window craniotomy and routine craniotomy treating 113 patients with hypertensive intracerebral hemorrhage(HICH).Methods All patients were confirmed the hypertensive supratentorial intracerebral hemorrhage by CT scan, and were divided into two groups: small window craniotomy group (n=57) and routine craniotomy group(n=56). Small window craniotomy group adopted small craniotomy according to hematoma sites. Routine craniotomy group adopted temporalparietal lobe or front temporal craniotomy flap(6 cm×8 cm) according to hematoma sites. Results There were statistically significant differences between small window craniotomy group and routine craniotomy group(P<0.05) by chisquare test analysis. Recovery in small window craniotomy group was better than routine craniotomy group, and longterm coma, the rate in the disability, brain edema and cerebrospinal fluid leakage of incision in small window craniotomy group was lower than routine craniotomy group(P<0.05).Conclusion The treatment effect of patients with HICH in small window craniotomy group is better than that in routine craniotomy group.
【Key words】 Small window craniotomy; Routine craniotomy; Hypertensive intracerebral hemorrhage
高血压脑出血(hypertensive intracerebral hemorrhage，HICH)是一种常见病，病死率为脑血管病患者的首位,占卒中病人的10% ～30%[1]，通常病情危重，存活者多有严重病残[2]。将我院2005—2008年符合入选标准的高血压脑出血病人113例采用小骨窗与常规骨瓣开颅术治
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