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目的探讨高血压脑出血的临床特点及微创颅内血肿清除术治疗优势。方法选取宾阳县人民医院2014年4月—2016年4月收治的高血压脑出血患者64例,随机将患者分为常规组与微创组,各32例。常规组患者行常规开颅血肿清除术,微创组患者行微创颅内血肿清除术,分析患者临床特点,比较两组患者手术时间、术中出血量、临床疗效。结果 64例患者中偏瘫占31.2%,格拉斯哥昏迷评分量表(GCS)评分为(7.7±0.3)分;神经功能缺损严重者占68.8%,神经功能缺损评分为(23.4±2.9)分;出血量较多者占54.7%,出血量为(22.0±3.1)ml;伴并发症者占78.1%。微创组患者手术时间短于常规组,术中出血量少于常规组,总有效率高于对照组,差异有统计学意义(P<0.05)。结论高血压脑出血患者多伴有偏瘫、神经功能缺损及各种并发症,采用微创颅内血肿清除术治疗可缩短手术时间,减少术中出血量,提高临床疗效。
Objective To investigate the clinical features of hypertensive cerebral hemorrhage and the advantages of minimally invasive intracranial hematoma resection. Methods Sixty-four patients with hypertensive intracerebral hemorrhage admitted from April 2014 to April 2016 in Binyang People’s Hospital were randomly divided into routine group and minimally invasive group, with 32 cases in each group. Patients in the conventional group underwent routine craniotomy, and patients in the minimally invasive group underwent minimally invasive intracranial hematoma resection. The clinical characteristics of the patients were analyzed. The operation time, intraoperative blood loss and clinical efficacy were compared between the two groups. Results Sixty-four patients had hemiplegia (31.2%), Glasgow Coma Scale (GCS) score of (7.7 ± 0.3), severe neurological deficit (68.8%) and neurological deficit (23.4 ± 2.9) More accounted for 54.7%, bleeding (22.0 ± 3.1) ml; with complications accounted for 78.1%. The operation time of patients in minimally invasive group was shorter than that of conventional group. The blood loss in operation was less than that of conventional group, and the total effective rate was higher than that of control group. The difference was statistically significant (P <0.05). Conclusions Patients with hypertensive intracerebral hemorrhage are often accompanied by hemiplegia, neurological deficits and various complications. The treatment of minimally invasive intracranial hematoma can shorten the operation time, reduce the intraoperative blood loss and improve the clinical efficacy.