微创术治疗高血压脑出血的临床研究

目的：探讨微创颅内血肿清除术在高血压脑出血治疗中的优越性。方法：保守组38例行内科综合治疗，开颅组38例在保守组治疗的基础上升骨瓣或骨窗，清除血肿，微创组36例在保守组治疗的基础上行CT片定位法微创颅内血肿清除术，比较三组治疗的有效率、死亡率和治疗前、后神经功能缺损评分，采用t和x^2检验比较。结果：保守组有效率42．1％，死亡率21．1％，开颅组有效率为55．3％，死亡率为10．5％，微创组有效率为91．7％，死亡率2.8％，微创组与开颅组和保守组比较均有显著性差异(P＜0．05)；微创组于治疗后第l天神经功能缺损评分即见明显减少，而开颅组和保守组均于治疗后第14天才有明显减少，微创组与开颅组和保守组比较均有显著性差异(P＜0．05)。结论：微创颅内血肿清除术在高血压脑出血治疗中能提高有效率、降低死亡率、加快神经功能恢复。

CLINCAL STUDY OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE TREATED BY MINIMALLY INVASIVE SURGERY

Objective:To evaluate the advantages of minimally invasive evacuation of hematoma for treatment of hypertensive intracerebral hemorrhage. Methods:Thirty-eight cases in group A received conservative medical treatment, 38 cases in group B received craniotomy based on medical treatment and 36 cases in group C received minimally invasive evacuation based on medical treatment. The effective rate,mortality and neurological deficit scale of three groups were compared, and statistical data were processed with chi-square test.Results:The effective rate and mortality in group C were 91.7% and 2.8%, respectively, which was significantly different from that in group A(42.1% and 21.1%,respectively, P <0.05) and group B(55.3% and 10.5%,respectively, P <0.05). Conclusion:The minimally invasive evacuation of hematoma can improve the effective rate, decrease the mortality and promote the recovery of neurological function in the treatment of hypertensive intracerebral hemorrhage.