小骨窗显微手术治疗高血压脑出血的应用研究

目的探讨小骨窗显微手术治疗高血压脑出血的疗效。方法20例高血压脑出血患者于发病后5~24h行小骨窗显微手术治疗,同期26例患者行小骨窗非显微手术,对两组的手术时间、术中出血量、血肿清除率、术后再出血率、颅内感染率、血肿完全吸收时间及术后3个月疗效进行对比研究分析。结果显微组生存19例,其中植物生存1例,死亡1例;非显微组生存22例,其中植物生存5例,死亡4例。两组的术中出血量无显著差异;显微组手术时间较非显微组延长;血肿清除率大于非显微组;术后再出血率及颅内感染率明显降低;血肿完全吸收时间明显较非显微组缩短。41例病人术后3个月随访,按日常活动生活质量标准(ADL)评定,显微组明显好于非显微组。结论小骨窗显微手术治疗高血压脑出血是一种安全有效的方法,疗效明显。

Microsurgery through the small skull window in the treatment of hypertensive intracerebral hemorrhage

Objective To explore the effect of microsurgery through the small skull window in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods Twenty patients with HICH whose hematomas were removed microscopically through the small skull window 5-24 hours after the onset of conditions were enrolled in the study.Twenty-six patients with HICH whose hematomas were removed non-microscopically through the small skull window wer selected as control. A comparison analysis of the two groups was made based on the duration of the operation,operative hemorrhage quantity,hematoma clearance rate, post-operation re-hemorrhage rate,intracranial infection rate ,hematoma complete absorbtion time and therapeutic effect 3 months after operation. Results In the microsurgery group,19 patients survived with 1 case in persistent vegetative state while 1 case died post-operatively . In the non-microsurgery group, 22 patients survived with 5 cases in persistent vegetative state while 4 cases died .There was no significant difference between the two groups in the operative hemorrhage quantity. Compared to the non-microsurgery group, the microsurgery group had a longer surgery duration,higher hematoma clearance rate, a significantly lower post-operation re-hemorrhage rate and intracranial infection rate and a shorter hematoma complete absorbtion time.In the 41 cases that were followed up,evaluation 3 months after operation according to the activities of daily living(ADL) indicated that the therapeutic effect of the microsurgery group was better than that of non-microsurgery group. Conclusion Microsurgery through the small skull window is a safe and effective method for treating HICH.