CAJ | 학술논문

目的：比较小骨窗颅内血肿清除术与微创穿刺血肿抽吸术治疗高血压性脑出血的临床疗效及安全性。方法选择符合标准的患者50例，随机分为观察组和对照组各25例，观察组应用小骨窗颅内血肿清除术，对照组应用微创穿刺血肿抽吸术，比较二者近期及远期临床疗效。结果观察组手术时间（56.22±8.20）min，长于对照组的（16.73±4.28）min，差异有统计学意义（P＜0.05）；观察组术后24 h血肿清除率（85.49±7.03）%、住院时间（20.16±3.49）d，对照组为（56.31±5.79）%、（26.82±5.50）d，差异有统计学意义（P＜0.05）。术前观察组NIHSS评分（11.46±3.53）分，对照组（11.52±3.67）分，差异无统计学意义（P＞0.05）；术后2周及4周观察组NIHSS评分（6.14±3.20）分、（3.42±1.92）分，对照组为（8.25±3.11）分、（5.30±2.75）分，二者NIHSS评分较术前均下降（P＜0.05），但是观察组下降幅度更大，差异有统计学意义（P＜0.05）。观察组ADL评价I级5例、II级8例、III级6例、IV级3例、V级2例和死亡1例，对照组ADL评价I级3例、II级5例、III级8例、IV级5例、V级3例和死亡2例，差异有统计学意义（P＜0.05）。观察组并发症发生率40.00%，与对照组的44.00%相似，差异无统计学意义（P＞0.05）。结论小骨窗颅内血肿清除术治疗高血压性脑出血，可有效清除颅内血肿，促进神经功能恢复，提高临床治疗效果。
목적：비교소골창로내혈종청제술여미창천자혈종추흡술치료고혈압성뇌출혈적림상료효급안전성。방법선택부합표준적환자50례，수궤분위관찰조화대조조각25례，관찰조응용소골창로내혈종청제술，대조조응용미창천자혈종추흡술，비교이자근기급원기림상료효。결과관찰조수술시간（56.22±8.20）min，장우대조조적（16.73±4.28）min，차이유통계학의의（P＜0.05）；관찰조술후24 h혈종청제솔（85.49±7.03）%、주원시간（20.16±3.49）d，대조조위（56.31±5.79）%、（26.82±5.50）d，차이유통계학의의（P＜0.05）。술전관찰조NIHSS평분（11.46±3.53）분，대조조（11.52±3.67）분，차이무통계학의의（P＞0.05）；술후2주급4주관찰조NIHSS평분（6.14±3.20）분、（3.42±1.92）분，대조조위（8.25±3.11）분、（5.30±2.75）분，이자NIHSS평분교술전균하강（P＜0.05），단시관찰조하강폭도경대，차이유통계학의의（P＜0.05）。관찰조ADL평개I급5례、II급8례、III급6례、IV급3례、V급2례화사망1례，대조조ADL평개I급3례、II급5례、III급8례、IV급5례、V급3례화사망2례，차이유통계학의의（P＜0.05）。관찰조병발증발생솔40.00%，여대조조적44.00%상사，차이무통계학의의（P＞0.05）。결론소골창로내혈종청제술치료고혈압성뇌출혈，가유효청제로내혈종，촉진신경공능회복，제고림상치료효과。
Objective To compare the clinical efficacy and safety between small bone window for removal of intracranial hematoma and minimally invasive evacuation of intracranial hematoma in the treatment of hypertensive cerebral hemorrhage. Methods 50 el-igible patients were selected and randomly divided into observation group and control group, with 25 patients in each group. The observation group used small bone window for removal of intracranial hematoma, while the control group used minimally invasive evacuation of intracranial hematoma. And the short-term and long-term clinical efficacies were compared between the patients of the two groups. Results The operative time of the observation group was (56.22±8.20) min, longer than the control group's (16.73± 4.28) min, the difference was statistically significant (P<0.05); The hematoma clearance rate within 24h after the operation in the observation group was (85.49±7.03)%, the length of stay was (20.16±3.49) d, and that of the control group was (56.31±5.79)%, (26.82±5.50) d, respectively, the difference was statistically significant (P<0.05). Before operation, The NIHSS score was (11.46± 3.53) points in the observation group, and that was (11.52±3.67) points in the control group, the difference was not statistically sig-nificant (P>0.05);The NIHSS score of the observation group 2, 4 weeks after the operation was (6.14±3.20) points, (3.42±1.92) points, respectively, and that of the control group was (8.25±3.11) points, (5.30±2.75) points, respectively, the NIHSS scores of both groups decreased compared with those before operation (P<0.05), but the observation group had a larger decline, the difference between the groups was statistically significant (P<0.05). By the ADL evaluation, in the observation group, there were 5 cases with grade I, 8 cases with grade II, 6 cases with grade III, 3 cases with grade IV, 2 cases with grade V, 1 case died, in the control group, there were 3 cases with grade I, 5 cases with grade II, 8 cases with grade III, 5 cases with grade IV, 3 cases with grade V, 2 cases died, the difference was statistically significant (P<0.05). The incidence of complications of the observation group was 40.00%, similar to 44.00%of the control group, the difference was not statistically significant (P>0.05). Conclusion Small bone window for removal of intracranial hematoma in the treatment of hypertensive cerebral hemorrhage can effectively remove the intracranial hematoma, promote the rehabilitation of nerve function, and elevate the clinical efficacy.