微创血肿清除术治疗高血压脑出血的疗效观察

目的：探讨微创血肿清除术治疗高血压脑出血（HICH）的临床疗效。方法：选取在我院治疗的HICH患者90例，随机分为治疗组和对照组，治疗组接受微创血肿清除术。对照组接受保守疗法。结果：术后3个月ADL分级中治疗组Ⅰ级、Ⅱ级、Ⅲ级例数明显多于对照组，Ⅳ级及死亡人数明显少于对照组，两者比较差异具有显著性（P〈0．05），出血量≤60ml组治疗有效率为96．43％，死亡率为0；出血量〉60ml组有效率为47．06％，死亡率为17．65％；两者比较差异均具有显著性（P〈0．05）、治疗组首次清除率为45％-78％，总清除率为80％-95％：治疗组死亡3例，其中1例24h内死于脑弛、呼吸衰竭。2例死于术后肺部感染，结论：微创血肿清除术治疗HICH具有诸多优点。临床应严格掌握适应证及手术时机.

Observation on effect of minimally invasive clear operation in treating hypertensive intracerebral hemorrhage

Objective：To invesgate the chnical curative effects of minimally invasive clear operation in treating hypertensive intracerebral hemorrhage （HICH）.Methods：90 cases with hypertensive intracerebral hemorrhage were selected from January 2006 to January 2008,and were divided into the treatment group and control group. The teatment group received the minimally invasive operation,and the control group received the conservative treatment.Results：The patients of gradeⅠ , Ⅱand Ⅲ for ADL grade after of three months operation in the treatment group were more than those in the control group, and the dead patients in the treatment group were fewer than those in the control group,so there was signifieant difference between two groups （P〈0.05）. The effective power was 96.43% and the death rate was 0 in hemorrhage fewer than 60 ml group,and the effective power was 47.06% and the death rate was 17.65% in hemorrhage moer than 60 ml group,so there was significant difference between two groups （P〈0.05）. The first time clearance rate of the treatment group was from 45% to 78%, and the total body clearance was from 80% to 95%.The 3 patients were dead, the causes of death in 1 patient was brain hernia and respiratory failure happening in 24h, and the causes of death in 2 patients were pulmonary infections after operations. Conclusion：There are many merits of minimally invasive clear operation in treating HICH, the clinic should use it on foundation of grasping the indication and chance of operation strietively.