Xu Zhanyi, Sun Zhaosheng, Xu Min, Zhao Baoshuai, Wei Jianhui, Guo Hong, Li Yongqian, Mao Jianhui
Department of Neurosurgery, Hengshui People's Hospital, Hengshui, Hebei, China.
Department of Prevention and Health Care, Hengshui People's Hospital, Hengshui, Hebei, China.
Neurol India. 2022 Sep-Oct;70(5):2047-2052. doi: 10.4103/0028-3886.359215.
Hypertensive intracerebral hemorrhage (HICH) seriously endangers the quality of life of patients and can even lead to death. Craniotomy is a common treatment method for HICH.
The aim of this study was to investigate the efficacy of two different sizes of craniotomy in patients with HICH, as well as to evaluate their effects on C-reactive protein (CRP) and blood lactate levels.
A total of 72 patients with HICH in the basal ganglia were operated on in our hospital from February 2017 to March 2019 and randomly divided into two groups: the small bone window (SBW) group (n = 37) and the large bone flap group (n = 35). The curative effects of the two kinds of operations were evaluated by the length of operation, the days of hospitalization, the rate of hematoma clearance, the rate of rebleeding, and the incidence of complications. Additionally, the levels of CRP and lactate were compared between the two groups.
The results showed that the average intraoperative time, hospital stay, rebleeding rate, and postoperative complications of patients in the SBW group were less than those in the large bone flap group. Moreover, the number of patients in the SBW group with good postoperative recovery, including class V and class IV, was higher than that in the large bone flap group. Minimally invasive craniotomy with SBW reduced the lactic acid and CRP levels more quickly than the large bone flap group.
An SBW was superior to a large bone flap in terms of the operative effect and lactate and CRP levels. It is concluded that an SBW has significant advantages over a large bone flap.
高血压性脑出血(HICH)严重危及患者生活质量,甚至可导致死亡。开颅手术是HICH的常见治疗方法。
本研究旨在探讨两种不同大小开颅手术治疗HICH患者的疗效,并评估其对C反应蛋白(CRP)和血乳酸水平的影响。
2017年2月至2019年3月,我院共对72例基底节区HICH患者进行手术,并随机分为两组:小骨窗(SBW)组(n = 37)和大骨瓣组(n = 35)。通过手术时长、住院天数、血肿清除率、再出血率及并发症发生率评估两种手术的疗效。此外,比较两组患者的CRP和乳酸水平。
结果显示,SBW组患者的平均术中时间、住院时间、再出血率及术后并发症均少于大骨瓣组。此外,SBW组术后恢复良好(包括Ⅴ级和Ⅳ级)的患者数量高于大骨瓣组。采用SBW的微创开颅手术比大骨瓣组更快降低乳酸和CRP水平。
在手术效果以及乳酸和CRP水平方面,SBW优于大骨瓣。得出结论,SBW相对于大骨瓣具有显著优势。