高血压脑出血外科治疗探讨

目的探讨高血压脑出血外科手术方式的选择及其疗效。方法2002年6月～2007年6月采用微创穿刺引流术、小骨窗开颅、骨瓣开颅三种术式治疗高血压脑出血患者352例。结果存活314例（89.2%），按ADL分级：Ⅰ级169例，Ⅱ级62例，Ⅲ级30例，Ⅳ级28例，Ⅴ级25例。死亡38例（10.8%）。结论对出血部位及出血量不同的患者采用不同的手术方式及选择恰当的手术时机能明显的降低病死率及致残率，提高治愈率。

Exploration on surgical treatment for hypertensive intracerebral hemorrhage

Objective To explore the therapeutic efficacies of different surgical operating methods for hypertensive intracerebral hemorrhage. Methods From June 21302 to June 2007, 352 cases of hypertensive intracerebral hemorrhage had been treated by intracranial puncture and drainage or craniotomy through small bone window or craniotomy through bone flap. Results 314 patients survived （89.2%）, according to ADL,169 cases were in grade Ⅰ,62 in grade Ⅱ,30 in grade Ⅲ, 28 in grade Ⅳ and 25 in grade Ⅴ. 38 patients died （10.8%）. Conclusions Individualized surgical timing and mode can decrease mortality and disability rate markedly according to cases with different hematoma situation and volumes.