CAJ | 학술논문

目的：探究小骨窗血肿清除术与传统开颅手术治疗脑出血的临床应用和效果。方法选取脑出血患者90例，按数字表法随机分为对照组和观察组，观察组45例给予小骨窗血肿清除术治疗，对照组45例给予传统开颅清除血肿手术，记录并比较两组的手术时间、输血量、血肿清除率、残留血肿量，GOS量表，术后追访一年再住院率，病死率，Barthel指数评分，比较两组手术疗效。结果观察组手术时间为（92．5±18．1）min，显著低于对照组的（125．6±20．3）min，差异具有统计学意义（P＜0．01）；观察组输血量为（125．0±23．4）mL，显著低于（325．0±104．5）mL，差异具有统计学意义（P＜0．01）；而两组的血肿清除率和残留血肿量比较差异无统计学意义（ P＞0．05）。观察组的有效率达91．1％，显著高于对照组的62.2％，差异具有统计学意义（P＜0.01）。术后追访一年，观察组再住院率和病死率为20．0％和5．0％，均显著低于对照组42．1％和15．8％，而观察组的Barthel指数评分则显著高于对照组，差异均具有统计学意义（均P＜0．05）。结论小骨窗血肿清除术治疗脑出血患者临床疗效好，操作简便，创伤少，手术预后良好，值得临床进一步的推广。
목적：탐구소골창혈종청제술여전통개로수술치료뇌출혈적림상응용화효과。방법선취뇌출혈환자90례，안수자표법수궤분위대조조화관찰조，관찰조45례급여소골창혈종청제술치료，대조조45례급여전통개로청제혈종수술，기록병비교량조적수술시간、수혈량、혈종청제솔、잔류혈종량，GOS량표，술후추방일년재주원솔，병사솔，Barthel지수평분，비교량조수술료효。결과관찰조수술시간위（92．5±18．1）min，현저저우대조조적（125．6±20．3）min，차이구유통계학의의（P＜0．01）；관찰조수혈량위（125．0±23．4）mL，현저저우（325．0±104．5）mL，차이구유통계학의의（P＜0．01）；이량조적혈종청제솔화잔류혈종량비교차이무통계학의의（ P＞0．05）。관찰조적유효솔체91．1％，현저고우대조조적62.2％，차이구유통계학의의（P＜0.01）。술후추방일년，관찰조재주원솔화병사솔위20．0％화5．0％，균현저저우대조조42．1％화15．8％，이관찰조적Barthel지수평분칙현저고우대조조，차이균구유통계학의의（균P＜0．05）。결론소골창혈종청제술치료뇌출혈환자림상료효호，조작간편，창상소，수술예후량호，치득림상진일보적추엄。
Objective To explore the effect of craniotomy operation and keyhole minimally invasive opera-tion in the treatment of patients with cerebral hemorrhage .Methods 90 patients with cerebral hemorrhage were ran-domly divided into control group and observation group .45 cases in the control group were given conventional cranioto-my to clear hematoma ,45 cases in the observation group received keyhole minimally invasive operation .The operation time,blood transfusion amount , hematoma clearance rate , residual hematoma volume , GOS scale were recorded and compared between the two groups.Postoperative follow-up for one year,the rehospitalization rate,mortality,the Barthel index score,curative effect were compared .Results The operation time and blood transfusion amount of the observa-tion group were (92.5 ±18.1) min,(125.0 ±23.4) mL,which were significantly less than (125.6 ±20.3) min, (325.0 ±104.5)mL of the control group (P<0.01).And the hematoma clearance rate and the amount of residual hematoma between the two groups had no statistically significant differences (P>0.05).The effective rate of the ob-servation group(91.1%) was obviously higher than that of the control group (62.2%),the difference was statistically significant(P<0.01).The patients were followed up for one year postoperation ,the rehospitalization rate and mortali-ty of the observation group were 20.0% and 5.0%,which were significantly lower than those of the control group (42.1%,15.8%)(P<0.05).While the Barthel index score of the observation group was higher than that of the control group,the difference was significant (P<0.05).Conclusion Keyhole minimally invasive operation in the treatment of cerebral hemorrhage has good clinical curative effect ,with advantages of simple operation ,less trauma, good surgery prognosis ,which is worthy of further clinical promotion .