高血压脑出血的外科治疗

目的 探讨高血压脑出血病人外科治疗手段，提高此类病人的生存率和改善生存质量。方法根据病人高血压脑出血的部位、血肿量及血肿形态，采取不同的手术方法。围手术期的血压管理，并加强静脉营养。结果本组治疗127例不同类型的高血压脑出血病人，良好15例（11．8％），中残44例（34．6％），重残36例（28．3％），植物生存9例（7．1％），死亡23例（18．1％）。结论依据病人情况，治疗以清除血肿、减轻手术副损伤，内减压或内外减压，严格适度地控制血压．加强并发症的防治，高血压脑出血的外科治疗效果是令人满意的。

Surgical treatment of hypertensive cerebral hemorrhage

Objective To explore the method of surgical treatment with hepertensive intracerebral hemorrhage by surgical treatment to improve survival rate and life quality of patients. Methods Different surgical procedures were undergone on the basis of the site and size of the ICH, such as CT guided drilling drainage, decompressive craniectomy and external ventricular drainage flushing with urokinase. Pre and postoperative blood pressure controlling is essential, Rusults Of 127 patients with hypertensive intracerebral hemorrhage, 15 (11.8%) were totally recovered, 44 ( 34. 6%) moderately disabled, 36 ( 28. 3%) severely disabled.9(7. 1%) persistent vegetative, 23(18. 1%) were dead. Conclusions According to the site, size and shape of hematoma, space occupying effect, and pre & post-operative situation of patients, we treated them by clearing hematoma, avoiding iatrogenic injury, internal and external decompression, blood pressure controlling, complication prevention and nutritional support, etc. The effect of surgical treatment of hypertensive intracerebral hemorrhage is satisfyied.