摘要
目的探讨小骨瓣经侧裂入路血肿清除术治疗高血压脑出血的临床效果。方法选择80例高血压脑出血患者作为研究对象,根据手术方案的不同分为对照组(40例,实施大骨瓣经颞叶入路血肿清除术)与研究组(40例,实施小骨瓣经侧裂入路血肿清除术)。比较两组患者手术指标、并发症发生情况、手术前后原始的脑出血量表(OICH)评分及术后不同时间日常生活活动能力评估量表(ADL)评分。结果研究组手术时间(96.54±10.46)min短于对照组的(124.81±10.79)min,术中出血量(86.92±10.78)ml少于对照组的(143.78±10.82)ml,血肿清除率(87.86±1.14)%高于对照组的(79.92±1.18)%(P<0.05)。对照组并发症发生率为20.00%,研究组并发症发生率为5.00%;研究组并发症发生率显著低于对照组(P<0.05)。术前,两组OICH评分比较未见显著差异(P>0.05);术后,研究组OICH评分(1.21±0.14)分显著低于对照组的(1.68±0.12)分(P<0.05)。两组术后2周ADL评分比较未见显著差异(P>0.05);研究组术后3、6个月ADL评分分别为(76.15±6.35)、(86.16±6.74)分,均较对照组的(69.37±4.23)、(75.18±5.82)分明显更高(P<0.05)。结论相较于大骨瓣经颞叶入路血肿清除术,小骨瓣经侧裂入路血肿清除术在高血压脑出血的临床治疗中更具应用价值。
Objective To explore the clinical effect of small bone flap transsylvian approach for hematoma removal in hypertensive intracerebral hemorrhage.Methods A total of 80 patients with hypertensive intracerebral hemorrhage were selected as the study subjects and divided into control group(40 cases,large bone flap through temporal-cortex approach for hematoma removal)and study group(40 cases,small bone flap transsylvian approach for hematoma removal)according to different surgical procedures.Patients in both groups were compared in terms of the surgical indexes,the occurrence of complications,the original intracerebral hemorrhage scale(OICH)score before and after surgery,and the activities of daily living(ADL)scores at different time points after surgery.Results The study group had shorter operation time of(96.54±10.46)min than(124.81±10.79)min in the control group,less intraoperative blood loss of(86.92±10.78)ml than(143.78±10.82)ml in the control group,and higher hematoma removal rate of(87.86±1.14)%than(79.92±1.18)%in the control group(P<0.05).The incidence of complications was 20.00%in the control group and 5.00%in the study group;the incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Before surgery,there was no significant difference in OICH score between the two groups(P>0.05).After surgery,the study group had significantly lower OICH score of(1.21±0.14)points than(1.68±0.12)points in the control group(P<0.05).There was no significant difference in ADL scores between the two groups at 2 weeks after surgery(P>0.05).ADL scores of the study group were(76.15±6.35)and(86.16±6.74)points at 3 and 6 months after surgery,which were significantly higher than(69.37±4.23)and(75.18±5.82)points in the control group(P<0.05).Conclusion Compared with large bone flap through temporal-cortex approach,the small bone flap transsylvian approach for hematoma removal is more valuable in the clinical treatment of hypertensive intracerebral hemorrhage.
作者
王业绩
WANG Ye-ji(Shan County Haijiya Hospital,Heze 274300,China)
出处
《中国实用医药》
2025年第3期38-41,共4页
China Practical Medicine
关键词
小骨瓣经侧裂入路血肿清除术
大骨瓣经颞叶入路血肿清除术
高血压脑出血
Small bone flap transsylvian approach for hematoma removal
Large bone flap through temporal-cortex approach for hematoma removal
Hypertensive intracerebral hemorrhage
