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[摘 要] 目的 探討开颅血肿清除术与微创钻孔引流术治疗高血压脑出血的临床疗效. 方法 方便选取2010年5月—2016年9月入住该院神经外科的高血压脑出血患者56例,采用开颅血肿清除术的对照组患者30例,微创钻孔引流的实验组患者26例,比较两组患者术后3个月ADL分级、术后病死率及并发症情况.结果 术后两组生存患者3个月ADL分级比较,实验组Ⅰ～Ⅲ级者为18例（75%）,开颅组为11例（44%）,两组ADL分级比较,差异有统计学意义（χ2等于4.871,P<0.05）.实验组肺部感染发生率34.6%,对照组63.3%,两组肺部感染发生率比较,差异有统计学意义（P<0.05）.死亡率实验组7.7%、对照组16.7%,术后再出血发生率实验组11.5%、对照组16.7%,应激性溃疡发生率实验组7.7%、对照组13.3%,脑梗塞发生率实验组3.8%、对照组16.7%,两组患者死亡率及术后再出血、应激性溃疡、脑梗塞发生率比较,差异无统计学意义（P>0.05）. 结论 微创钻孔引流术对高血压脑出血具有较好的治疗效果,且在一定程度上优于开颅血肿清除术.
[关键词] 微创钻孔引流术；开颅血肿清除术；高血压脑出血；ADL评分
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）03（a）-0073-03
Comparison of the Clinical Efficacy of Craniotomy Hematoma Removal and Minimally Invasive Drilling and Drainage in the Treatment of Hypertensive Intracerebral Hemorrhage
WU Wang-chun, CHEN Shui-yu, PENG Yan-guo, JI Xue-cheng
Department of Neurosurgery, Mindong Hospital Affiliated to Fujian Medical University, Fu’an, Fujian Province, 355000 China
[Abstract] Objective This paper tries to discuss the clinical efficacy of craniotomy hematoma removal and minimally invasive drilling drainage in the treatment of hypertensive cerebral hemorrhage. Methods 56 cases of patients with hypertensive cerebral hemorrhage from May 2010 to September 2016 in this hospital were convenient selected and divided into two groups. The control group of 30 cases received craniotomy hematoma removal surgery, while the experimental group of 26 cases underwent minimally invasive drainage. The ADL, mortality and complications in three months after surgery were observed and recorded. Results Three months after the operation, the ADL grade of the two groups of survival patients was compared, 18 cases（75%） in the experimental group I to grade III and 11（44%） in the craniotomy group. The two groups ADL grading were compared（χ2等于4.871, P<0.05）, and their difference was statistically significant. The incidence of pulmonary infection in the experimental group was 34.6%, and the control group was 63.3%. There was a significant difference in the incidence of pulmonary infection between the two groups（P<0.05）. The mortality was 7.7% in the experimental group and 16.7% in the control group. The incidence of rehaemorrhagia after operation was 11.5% in the experimental group and 16.7% in the control group. The incidence of stress ulcer was 7.7% in the experimental group and 13.3% in the control group. The incidence of cerebral infarction was 3.8% in the experimental group and 16.7% in the control group. There was no significant difference in the rate of mortality, postoperative rehaemorrhagia, stress ulcer and cerebral infarction between the two groups（P>0.05）. Conclusion Minimally invasive drilling and drainage has a good therapeutic effect on hypertensive intracerebral hemorrhage and is superior to craniotomy hematoma evacuation to a certain extent.
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参考文献：
1、 七叶皂苷钠联合甘露醇治疗脑出血临床疗效 【摘要】 目的 分析七葉皂苷钠联合甘露醇治疗脑出血的临床疗效。方法 86例脑出血患者， 随机分为观察组与对照组， 各43例。两组除了给予常规的基。
2、 阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死临床疗效分析 【摘要】 目的 分析阿司匹林联合硫酸氢氯吡格雷口服治疗脑梗死的临床疗效。方法 88例脑梗死患者， 随机分为对照组和观察组， 每组44例。对照组患。
3、 个体化手术策略治疗高血压脑出血临床 【摘要】 目的 研究个体化手术策略治疗高血压脑出血的临床效果。方法 106例高血压脑出血患者作为研究对象， 对所有患者的临床资料进行回顾性分析，。
4、 钻孔微创血肿清除术治疗糖尿病合并脑出血的临床效果 DOI：10 16658 j cnki 1672-4062 2016 17 131[摘要] 目的 观察研究钻孔微创血肿清除术治疗糖尿病合并脑出。
5、 脑出血急性期合并糖尿病的临床护理分析 [摘要] 目的 对脑出血急性期合并糖尿病患者的临床护理情况进行探析。方法 回顾分析2016年5月—2017年2月日照市中医医院收治的97例脑出血。
6、 显微手术治疗前循环脑动脉瘤临床疗效 摘 要 目的：研究显微手术治疗前循环脑动脉瘤的效果。方法：选择2014年1月至2016年5月收治的40例前循环脑动脉瘤患者，随机分为对照组20例。