目的：分析高血压脑出血患者采用微创钻孔引流术与开颅血肿清除术治疗的效果差异。方法将我院收治的高血压脑出血患者120例纳入本研究，根据随机数字表法分为2组，将应用开颅血肿清除术治疗的60例患者设为开颅组，应用微创钻孔引流术治疗的60例患者设为微创组。对比2组患者术前术后的血肿量、术后神经功能缺损评分和日常生活活动能力（ADL ）评分、术后并发症及病死率情况。结果微创组术后1、3、5 d的血肿量与开颅组相比明显较低，差异有统计学意义（ P ＜0.05）。微创组术后2周神经功能缺损评分和术后3个月的ADL评分与开颅组相比较为优异，差异有统计学意义（ P ＜0.05）；微创组的并发症发生率（6．7％）与对照组（28．3％）相比明显较低，差异具有统计学意义（P ＜0.05），但微创组和开颅组术后病死率（1．7％、3．3％）差异无统计学意义（ P ＞0.05）。结论采用微创钻孔引流术治疗高血压脑出血的效果显著，明显优于开颅血肿清除术，血肿清除率较高，对患者神经功能的损伤较少，并发症较少发生，病死率低，患者ADL有所提高，值得在临床上推广应用。%Objective To analyze the effect of minimally invasive drilling and drainage and craniotomy he‐matoma removal in the treatment of hypertensive cerebral hemorrhage patients. Methods One hundred and twenty cases of hypertensive cerebral hemorrhage patients were randomly divided into two groups according to the digital table method .Sixty cases treated with craniotomy hematoma removal were in craniotomy group ,and 60 cases trea‐ted with minimally invasive drilling and drainage were in minimally invasive group .The postoperative hematoma volume ,postoperative neurological function defect score ,ADL score ,postoperative complications and mortality were compared between the two groups .Results Hematoma volumes in 1 ,3 ,and 5 d in the minimally invasive group were significantly lower than those in the craniotomy group ( P <0.05) .The neurological function defect score and postoperative ADL score in 2 week in the minimally invasive group were better than those in the craniot‐omy group ( P <0.05);the complication rate (6.7% ) in the minimally invasive group was significant lower than that (28.3% ) in the control group ( P <0.05) ,but the mortality rate (1.7% ,3.3% ) after surgery was of no significant difference between the minimally invasive group and the craniotomy group ( P >0.05) .Conclusion Minimally invasive drilling and drainage in the treatment of hypertensive cerebral hemorrhage is significant better than craniotomy hematoma removal .Its hematoma clearance rate is higher ,nerve function damage and complica‐tions are less ,mortality is low and daily life activity ability in the patients receiving this treatment is higher .It is worthy of clinical application .
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