小骨窗微创手术用于治疗老年高血压性脑出血合并脑疝的疗效及其安全性

doi:10.3969/j.issn.1003-9198.2023.05.013

Abstract

Abstract: Objective To compare the clinical efficacy and safety between minimally invasive surgery with small bone window and traditional large bone flap craniotomy in the elderly patients with hypertensive intracerebral hemorrhage complicated with cerebral herniation. Methods The clinical data of 76 elderly patients with hypertensive intracerebral hemorrhage complicated with brain herniation were retrospectively analyzed, and they were divided into the small bone window group(n=36, receiving minimally invasive surgery with small bone window) and the large bone flap group(n=40, receiving large bone flap craniotomy). The hematoma clearance rate, pupil recovery rate, brain hernia recovery rate and the score of Glasgow coma scale(GCS) within 24 hours after operation, operation time, length of incision, intraoperative blood loss, and short-term and long-term clinical effects of the two groups were compared. The incidence of complications 2 weeks after operation in both groups was recorded. Results There were no differences in pupil recovery rate, brain hernia recovery rate and the score of GCS within 24 hours after operation between the two groups(P>0.05). The hematoma clearance rate was lower, the operative time and intraoperative blood loss were less, and the length of incision was shorter in the small bone window group than those in the large bone flap group(P<0.05 or P<0.01). The incidence rates of stress ulcer and wound healing in the small bone window group were better than those in the large bone flap group 2 weeks after operation(P<0.05 or P<0.01). However, there were no differences in the incidence rates of pulmonary infection and rebleeding beween the two groups (P>0.05). The short- and long-term good rates in the small bone window group were better than those in the large bone flap group(all P<0.05). Conclusions Compared with large bone flap craniotomy, minimally invasive surgery with small bone window is more suitable for the treatment of the elderly patients with hypertensive intracerebral hemorrhage complicated with brain herniation.

Key words: intracerebral hemorrhage, hypertension, minimally invasive, cerebral hernia, aged, small bone window

CLC Number:

R 743.34

XIA Heng, SHI Lei. Efficacy and safety of minimally invasive surgery with small bone window in the treatment of senile hypertensive intracerebral hemorrhage complicated with cerebral herniation[J]. Practical Geriatrics, 2023, 37(5): 487-490.

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Efficacy and safety of minimally invasive surgery with small bone window in the treatment of senile hypertensive intracerebral hemorrhage complicated with cerebral herniation

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