细孔钻颅血肿引流术与骨瓣开颅手术对高血压脑出血患者的疗效对比及临床价值分析.doc

精品论文 参考文献 细孔钻颅血肿引流术与骨瓣开颅手术对高血压脑出血患者的疗效对比及临床价值分析 （陕西省咸阳市第一人民医院神经外科 陕西咸阳 712000） 　　【摘要】目的：探讨细孔钻颅血肿引流术与骨瓣开颅手术对高血压患者的临床疗效及价值分析。方法：2013年3月至2014年3月行手术治疗高血压脑出血患者237例临床资料，按照手术方式分为细孔钻颅血肿引流术179例（钻孔组）和骨瓣开颅手术158例（开颅组）；治疗后,观察两组患者临床疗效、住院时间、手术时间、术后血肿清除率并发症情况、SSS量表评价神经功能恢复状况。结果：治疗后，钻孔组总有效率为95.0%，开颅组总有效率86.1%，两组相比，钻孔组高于开颅组（chi;2=4.628,P＜0.05）；钻孔组在住院时间、手术时间方面明显低于开颅组（P＜0.05）；而在血肿清除率方面无明显差异（P＞0.05）；钻孔组肺部感染、术后再出血、应激性溃疡、电解质紊乱均显著低于开颅组（P＜0.05）；而在颅内感染差异无统计意义（P＞0.05）；两组患者在术前、术后15dSSS评分差异无统计学意义（P＞0.05）；在术后30dSSS评分方面钻孔组优于开颅组，差异具有统计学意义（P＜0.05）。结论：细孔钻颅血肿引流术清除血肿效果好，并发症少，术后神经功能恢复快，能提高患者的生存质量，值得临床推广应用。 　　【关键词】细孔钻颅；骨瓣开颅；高血压脑出血；疗效对比；价值分析 　　【中图分类号】R651 【文献标识码】A 【文章编号】1007-8231（2016）12-0016-03 　　Analysis the effect and clinical value of pore cranial drilling hematoma drainage and craniotomy operation in treatment of patients with hypertensive cerebral hemorrhage 　　Wang anbang,Yang shaowei,Gao Changqing,Xie yu,Ma xiaohu,Dong fada. Department of Neurosurgery,the First People,s Hospital of Xianyang,Xianyang712000,China 　　【Abstract】Objective To explore the effect and clinical value of pore cranial drilling hematoma drainage and craniotomy operation in treatment of patients with hypertensive cerebral hemorrhage.Methods 2013 March to 2014 March for operation in treatment of hypertensive cerebral hemorrhage clinical data of 237 patients, according to the operation mode is divided into pore cranial drilling hematoma drainage in 179 cases (drilling group) and 158 cases of craniotomy operation (craniotomy group); after treatment, two groups were observed in patients with clinical efficacy, operation time, hospitalization time, postoperative hematoma clearance rate of complications, the SSS scale to evaluate the recovery of neurological functions.Results After treatment, drilling group total effectiveness is 95%, craniotomy group total effectiveness 86.1%, two groups compared with drilling group was higher than that of craniotomy group (chi;2=4.628,Plt;0.05); drilling gro