高血压脑出血60例手术治疗分析

目的探讨手术治疗对高血压脑出血的临床效果。方法对我科2004-09~2006-06收治的60例高血压脑出血患者的临床资料进行回顾性分析。结果开颅手术20例,存活13例(65%),恢复良好5例(38.5%),中、重残8例(61.5%),死亡7例(35%);小骨窗开颅术40例,存活35例(87.5%),恢复良好26例(74.3%),中、重残9例(25.7%),死亡5例(12.5%)。小骨窗开颅术后,病人的存活率和恢复情况均高于开颅手术组,病死率明显低于开颅手术组。结论高血压脑出血外科治疗能及时针对病因清除血肿,消除占位,制止出血,降低颅内高压,稳定颅内环境,阻断脑继发性损害,使病损的脑组织得以修复,达到康复。手术治疗能明显地提高存活率,小骨窗开颅术要比开颅手术为优,既能提高存活率,又能大大提高存活质量,是一种治疗高血压脑出血安全、及时、有效的手术方式。

Clinical analysis of minimally invasive therapy for hypertensive intracerebral hemorrhage

Objective To compare clinical outcomes between craniotomy via small bone flap and conventional method for hypertensive intracerebral hemorrhage. Methods A total of 60 cases of hypertensive intracerebral hemorrhage received either craniotomy via small bone flap(n=40) or large bone flap(n=20) from September 2004 to June 2006 in this hospital.Postoperative outcomes between the two groups were compared.Results Both the survival and recovery rates of patients in small bone flap craniotomy group were significantly higher than that of large bone flap craniotomy group.However,the mortality of the small bone flap craniotomy group was significantly lower than that of the other group. Conclusion Application of craniotomy via small bone flap in the treatment of hypertensive intracerebral hemorrhage can give a much more satisfactory effect.