目的 探讨不同手术治疗方法在高血压脑出血患者中的疗效对比观察。方法 选取90例高血压脑出血患者,按手术方式分为钻孔引流术组（研究组）、骨瓣开颅术治疗组（对照组）,每组各45例。记录2组患者的手术指标,使用格拉斯哥预后评分评价疗效,术前、术后7 d、术后15 d使用美国国立卫生研究院卒中量表（NIHSS）评估患者神经受损情况,手术前后选择36条目健康量表（SF-36）中的4个子量表（社会功能、躯体功能、角色功能以及认知功能）评估2组患者的生存质量,观察2组患者的术后并发症发生情况。结果 与对照组相比,研究组血肿清除率较高、术中出血量较少、手术时间较短（P均< 0.05）。研究组临床疗效优于对照组（P < 0.05）。术后7、15 d,2组的NIHSS评分均比术前逐渐下降（P均< 0.017）,且研究组的NIHSS评分均低于对照组（P均< 0.05）。术后2组患者的社会功能、躯体功能、角色功能、认知功能分值均高于术前,其中研究组的SF-36各项分值均高于对照组（P均< 0.05）。研究组术后出血1例、感染1例,并发症发生率为4%;对照组术后出血4例、感染4例,并发症发生率为18%。研究组术后并发症发生率低于对照组（P < 0.05）。结论 钻孔引流术治疗高血压脑出血患者,能有效清除颅内血肿、改善脑神经损伤、提高患者生存质量,且安全性高。

Objective To compare the clinical efficacy between different surgical methods for patients with hypertensive intracerebral hemorrhage.Methods Ninety patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2017 to January 2018 were randomly divided into the drilling and drainage group （study group, n = 45） and craniotomy group （control group, n = 45）. Surgical parameters of two groups were recorded. The clinical efficacy was evaluated by Glasgow prognostic score. The severity of neurological impairment was assessed by National Institute of Health Stroke Scale （NIHSS） before, 7 d and 15 d after surgery. The quality of life was assessed by 4 sub-scales （social function, physical function, role function and cognitive function） of 36-item short-form health survey （SF-36）. The incidence of postoperative complications was observed intwo groups.Results In the study group, the removal rate of hematoma was significantly higher, intraoperative blood loss was considerably less, the operation time was remarkably shorter and clinical efficacy was significantly better compared with those in the control group （all P < 0.05）. At postoperative 7 and 15 d, the NIHSS scores were gradually declined （both P < 0.017）. The NIHSS score in the study group was significantly lower than that in the control group （both P < 0.05）. Postoperatively, the scores of social function, physical function, role function and cognitive function were significantly increased in two groups, and the score of each item of SF-36 in the study group was remarkably higher than that in the control group （all P < 0.05）. In the study group, postoperative hemorrhage occurred in 1 patient and infection was observed in 1 case with an incidence rate of 4%. In the control group, hemorrhage occurred in 4 patients and infection was observed in 4 cases with an incidence rate of 18%. The incidence rate of postoperative complications in the study group was significantly lower than that in the control group （P < 0.05）.Conclusion For patients with hypertensive intracerebral hemorrhage, drilling and drainage can effectively and safely remove intracranial hematoma, mitigate brain nerve injury and improve the quality of life.