高血压脑出血手术治疗的选择

高血压脑出血(hypertensive intracerebral hemorrhage,HICH)是严重威胁人类健康的疾病之一,高血压脑出血外科手术治疗在治疗时间上有两种观点,即超早期及早期手术;手术方式上大致为两种,微侵袭手术(血肿穿刺引流术)和开颅血肿清除术。高血压性脑出血超早期手术即在出血后6 h以内手术清除血肿,但常有术后再出血;高血压性脑出血的血肿变化大多发生在起病后3~6 h以内,在发病6 h后进行手术,其安全系数增高。开颅血肿清除术适用于病情较重者(GCS<8分),而小骨窗开颅、血肿穿刺、立体定向内窥镜等微创方法适用于病情较轻者(GCS≥8分)。

The surgical choice of the hypertensive intracerebral hemorrhage

Hypertensive intracerebral hemorrhage （HICH） is one of serious diseases which threats to human health. It has both medical and surgical treatments. Surgical treatment has two views： Super early and Early surgery. The operation usually included minim invasive method and evacuation of hematoma by craniotomy. Super early surgery is the removal of hematoma within 6 hours after bleeding, but is possible to hemorrhage again after surgery. Because of the hematoma changes of HICH mostly occur within 3-6 hours, the safety coefficient increases when it operates after 6 hours. Craniotomy apply to serious patients （GCS〈8 points）, and minim invasive is applicable to the mild patients（GCS ≥ 8 points）.