开颅手术与锥颅抽吸治疗脑出血临床效果对比.doc

开颅手术与锥颅抽吸治疗脑出血的临床效果对比 　　[摘要]目的 探讨开颅手术与锥颅抽吸治疗脑出血的临床效果。方法 将2013年12月～2015年10月于我院确诊为脑出血并行手术治疗的81例患者纳入研究并随机分组，对照组40例患者行传统小骨窗开颅血肿清除术，治疗组41例患者则采用锥颅穿剌抽吸引流血肿清除术治疗，术后3 d复查头颅CT以观察出血灶吸收情况，比较两组临床疗效的差异。结果 治疗后，患者格拉斯哥昏迷评分（GCS）均提高，但治疗组改善更显著，且术后24 h的GCS评分属重度昏迷及死亡例数所占比例更少，差异有统计学意义（P0.05）。结论 脑出血开颅手术与锥颅抽吸均可获得较好疗效，但锥颅抽吸治疗方案创伤小，恢复快，值得推广 [关键词]脑出血；开颅手术；锥颅抽吸；疗效 [中图分类号] R743.34 [文献标识码] A [文章编号] 1674-4721（2016）08（a）-0046-03 [Abstract]Objective To investigate the clinical effect of craniotomy operation and cone skull suction therapy in treatment of cerebral hemorrhage.Methods Altogether 81 cases of patients who were diagnosed as cerebral hemorrhage and underwent parallel surgical treatment in our hospital from December 2013 to October 2015 were enrolled in the study and randomly divided into two groups，with 40 patients in control group and 41 cases in treatment group.Patients in the control group was treated with traditional small bone window craniotomy hematoma removal，while patients in the treatment group accepted skull puncture aspiration and bloody swollen clearance therapy.Post-operative 3 d CT （computerized tomography） was performed to observe hemorrhage absorption and the clinical curative effects in two groups were compared.Results Although GCS in two groups were increased post-operatively，a more remarkable improvement as well as the proportion of less cases of severe coma and death according to GCS after postoperative 24 hours was seen in treatment group，with a significant difference （P0.05）.Conclusion The craniotomy operation and cone skull suction therapy can obtain good curative effect in treatment of cerebral hemorrhage，among which the cone skull suction therapy is featured with less invasion and fast recovery and deserves wider popularization. 　　[Key words]Cerebral hemorrhage；Craniotomy；Cone skull suction；Curative effect 脑出血是一种临床常见危急重症，依据出血量不同及出血部位差异可出现剧烈头痛、偏身感觉障碍、对侧偏瘫、失语、认知障碍等临床表现，严重者可危及生命，具有较高的病死率和致残率[1-2]。手术是本病的主要治疗手段之一，虽然手术方案较多，但各种治疗手术方案的疗效报道差异较大，存在较大的争议。本文将对小骨窗开颅