不同微创手术治疗重症高血压脑出血的疗效比较

目的探讨重症高血压脑出血的有效治疗方法。方法对符合诊断标准的112例重症高血压脑出血患者随机分为3组,A组35例行锥颅血肿碎吸术,B组37例行锥颅穿刺引流液化术,C组40例行小孔多方位颅内血肿抽吸术。对患者术后的残留血肿量、中线移位、再出血率及病死率进行对比研究。结果术后A组与B组在病死率、残留血肿量、中线移位间差异均无统计学意义(P>0.05)。B组、C组与A组再出血率比较差异有统计学意义(P<0.05)。C组与A组、B组病死率、中线移位、残余血肿量相比差异有统计学意义(P<0.05)。结论重症脑出血病情恶化的主要影响因素为:血肿量,高颅内压,中线移位。小孔多方位颅内血肿抽吸术可有效降低颅内压,清除血肿,在治疗危重症高血压脑出血中能取得较好的效果。

Comparison on Effects of Different Minimally Invasive Surgeries for Seriously Cerebral Hemorrhage of Hypertension

Objective To explore the effective therapy for seriously cerebral hemorrhage of hypertension.Methods Totally 112 patients with seriously cerebral hemorrhage of hypertension were randomly divided into three groups.The 35 patients in group A were treated with the hematoma-breaking and suction through the skull-drilling,the 37 patients in group B with puncture drainage liquefaction through the skull-drilling,the 40 patients in group C with pinhole multi-locations hematoma suction.The postoperative residual volume of hematoma,mid-line deviation,re-hemorrhage rate and mortality among the patients after the treatment were compared and analyzed.Results There was no significant difference in mortality,residual volume of hematoma and mid-line deviation between group A and B (P>0.05).There was an obvious difference in re-hemorrhage rate between group C,B and A (P<0.05).There were obvious differences in mortality, mid-line deviation and residual volume of hematoma,between group C and B, A (P<0.05).Conclusion The chief influencing factors for deterioration of seriously cerebral hemorrhage are volume of hematoma,high intracranial pressure and mid-line deviation.The pinhole multi-locations intracranial hematoma suction may effectively reduce intracranial pressure and clean hematoma,which can obtain better results for acute and serious cerebral hemorrhage of hypertension.