【摘要】 目的探讨超早期小骨窗微创颅内血肿清除术治疗高血压脑出血(HICH)的临床疗效及对患者生活质量和血清内皮素(ET)、血管升压素(AVP)的影响。方法纳入2015年10月至2017年10月本院收治的96例HICH患者,根据随机数字表将患者均分为观察组和对照组,各48例,两组均在发病24h内进行手术,对照组行传统骨瓣开颅血肿清除手术治疗,观察组行小骨窗微创颅内血肿清除术治疗,比较两组围手术期相关指标、临床疗效、治疗前后生活质量和血清ET、AVP水平,并统计两组术后并发症情况。结果与对照组比较,观察组手术时间和住院时间显著缩短(P<0.05),两组血肿清除率相当(P>0.05);观察组治疗优良率为58.70%,显著高于对照组的40.00%(P<0.05);观察组术后的生理健康方面和精神健康方面的评分均显著高于对照组(P<0.05);两组术后7d的血清ET和AVP水平均显著低于术前(P<0.05),但组间数据差异比较无统计学意义(P>0.05);观察组合并再出血、肺部感染和脑梗死发生率分别为13.04%、8.70%、8.70%,与对照组的4.44%、22.22%、 20.00%比较差异有统计学意义(P<0.05)。结论对于HICH患者,给予超早期小骨窗微创颅内血肿清除术治疗疗效满意,具有手术时间短、术后恢复快和术后并发症少等优点,还可显著改善患者生活质量,降低血清ET和AVP水平,有临床应用价值。更多还原

【Abstract】 Objective To explore the clinical efficacy of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive intracerebral hemorrhage(HICH) with super-early small bone windows,and the influence on the quality of life of patients and serum endothelin(ET) and vasopressin(AVP). Method96 patients with HICH admitted from October 2015 to October 2017 in our hospital, according to the random number table method, the patients were divided equally into the observation group and the control group, 48 cases in each group. Both groups performed surgery within 24 hours of onset. The control group underwent traditional bone flap craniotomy and hematoma removal surgery. The observation group underwent minimally invasive surgery. intracranial hematoma removal surgery, related indicators of perioperative period, clinical efficacy, quality of life before and after treatment, serum ET and AVP levels were compared, and the incidence of postoperative complications was calculated.Results Compared with the control group, the operation time and length of stay in the observation group were significantly shorter(P<0.05), the hematoma clearance rate was comparable in both groups(P>0.05). The rate of treatment and treatment in the observation group was 58.70%, which was significantly higher than that in the control group was 40.00%(P<0.05). The scores of postoperative physical health and mental health in the observation group were significantly higher than those in the control group(P<0.05). The serum levels of ET and AVP at 7 days after surgery were significantly lower than before surgery(P<0.05), but there was no significant difference between the two groups(P>0.05). The incidences of combined rebleeding, pulmonary infection, and cerebral infarction were13.04%, 8.70%and 8.70%, respectively, compared with the control group 4.44%, 22.22%, 20%, there was a significant difference(P<0.05). Conclusion For patients with HICH, the treatment of super-early small bone windows for minimally invasive intracranial hematoma removal is satisfactory. It has the advantages of short operative time, rapid postoperative recovery, and less postoperative complications. It can also significantly improve the quality of life of patients and reduce serum ET and AVP levels have clinical value.更多还原