微创术和小骨窗开颅术治疗高血压脑出血的疗效观察(附34例临床分析)

目的探讨采用CT引导下立体定向置管加尿激酶溶凝块(微创术)和小骨窗开颅手术治疗高血压脑出血(HICH)病人的疗效。方法对高血压脑出血病人,分别采用微创术和小骨窗开颅手术治疗,观察治疗前后存活优良率、中重病残率、病死率、神经功能缺损评分。结果采用微创术治疗高血压脑出血组病人存活优良率高于小骨窗开颅手术组,病死率及病残率低于小骨窗开颅手术组,但无明显差异。而生存质量、格拉斯哥计分(GCS)、神经功能缺损评分明显改善,与小骨窗开颅手术组有显著性差异。结论采用微创术和小骨窗开颅手术均是较好的治疗高血压脑出血的手术途径,而术式的选择对患者的预后较为重要。

The therapy effect on hypertensive cerebral hemorrhage by micro-trauma operation and ossicle fenestration operation

Aim To investigate the therapy effect on hypertensive cerebral hemorrhage after adopting stereo orientation and puting vessel and using urokinase to dissolve blood clotting by CT localization(micro-trauma operation) as well as ossicle fenestration operation.Methods The hypertensive cerebral hemorrhage patients undrtwent micro-trauma operation or ossicle fenestration operation,and the patients' good survival rate,middle and severe disability rate,mortality and neurologic impairment scores were observed before and after the treatment.Results The patients' good survival rate,middle and severe disability rate have increased by micro-trauma operation,but there were no obvious difference from the ossicle fenestration operation group,while glasgow coma score(GCS),neurologic impairment scores were ameliorated obvipudly and significantly differ from that in the ossicle fenestration operation group.Conclusion Our data show that the micro-trauma operation and ossicle fenestration operation are better ways to theat the hypertensive cerebral hemorrhage.And the selection of operation style is also Tmportant to peognosis of the patients.