立体定向超早期和早期血肿抽吸术治疗高血压脑出血的研究

目的：研究立体定向超早期和早期血肿抽吸术治疗高血压脑出血的疗效。方法：通过ＣＴ导向立体定向血肿抽吸术治疗高血压脑出血患者１６３例，其中男１１６例，女４７例；年龄２８～８１岁，平均５４．５５岁。超早期抽吸４７例，早期抽吸５４例，延期抽吸６２例。结果：１６３例患者中存活１２９例，其中良好５６例（超早期２８例，早期１９例，延期９例），轻残３５例（超早期９例，早期１３例，延期１３例），中残２２例（超早期５例，早期８例，延期９例），重残１２例（早期３例，延期９例），植物生存４例均为延期手术者；死亡３４例，总病死率２０．８６％（超早期１０．６４％，早期２０．３７％，延期２９．０３％）。结论：定向超早期血肿抽吸术治疗高血压脑出血的疗效优于早期和延期血肿抽吸术；高血压脑出血患者应尽量争取超早期作定向血肿抽吸术，这对防止血肿压迫脑组织及血液分解产物对脑实质的不可逆性损害或产生脑水肿，降低病死率，提高生存质量都具有重要意义。

Study on CT guided stereotactic on extreme early and early aspirating hematoma in treatment of hypertensive cerebral apoplexy/

Objective:To study on efficacy of CTguided stereotactic on extreme early and early aspirating hematoma in the treatment of hypertensive cerebral apoplexy.Methods:163 cases(47 females and 116 males),aged from 28 to 81,average 54 55 years old,were treated with CTguided stereotactic aspirating hematoma.47 cases were performed on extreme early stage,54 cases on early stage and 62 cases on delay stage.Results:There were 129 survival among 163 patients.They consisted of 56 improvemental cases(extreme early stage:28,early stage:19 and delay stage:9),35 slight disablemental cases(extreme early:9,early:13 and delay stage:13),22 moderate disablemental cases (extreme early:5,early:8 and delay stage:9) and 12 severe disablemental cases(early:3 and delay stage:9).In addition,there were four stiffness in delay operation group,34 cases died,the total mortality was 20 86%(10 64% in extreme early,20 37% in early and 29 03% in delay stage group).Conclusions:The therapeutic efficacy of extreme early stereotactic aspirating hematoma on hypertensive cerebral apoplexy was better than that on early and delay stage aspiration;it was very important as early as possible to treat with stereotactic aspirating hematoma.There was an important significance in preventing brain tissue compressed by hematoma,blood cataboliteinduced reversible damage of brain parenchyma and edema formation.Otherwise,it could be decreasing mortality and increasing the life quality.