高血压脑出血个体化手术治疗方案的探讨

目的评价中小骨窗开颅术,去大骨瓣减压术及锥颅血肿抽吸治疗高血压脑出血的疗效。方法通过对37例去大骨瓣减压开颅和68例早期显微镜下斜切口中小骨窗开颅术以及42例锥颅血肿抽吸治疗高血压脑出血的观察比较各组死亡率。结果发现去大骨瓣组死亡9例,死亡率为24.3%,植物生存4例,中小骨窗组死亡11例,死亡率为16.4%。锥颅组死亡22例,死亡率为52.1%。中小骨窗组与去大骨瓣组在血肿清除程度、死亡率和早期预后等方面相差无显著差异,而与锥颅组差异明显。结论显微镜下超早期中小骨窗开颅手术能满足在直视下清除血肿的需要,又有手术时间短,创伤小,术中出血少等优点。是当前手术治疗高血压性脑出血的有效选择。

Explore Individuated Design of Craniotomy for Hypertensive Intracranial Hemorrhage

Objective To compare the efftiveness of difference types of operation for hypertensive intracerbral hemorrhage: middle or small bone flap,Lager cranial window and drill drainage.Methods In this study,147 patients were randomly divided into three groups: 37 patients treated by large craial window,and 68 patients by middle or small bone flap craniotomy and 42 patients by drill drainage.Results In the large bone flap decompression,9 patients(24.3%) died.In the small bone flap craniotomy,11 patients(16.2%) died.In the drill drainage,22 patients(52.4%) died.The effectiveness of large bone flap group and small bone flap group was better than that of drill drainage group,however,there was no significant difference between large bone flap group and middle or small bone flap goups.Conclusions The craniotomy with small bone flap is as same effectiveness and safety as traditional routine craniotomy is.And it is the minimally invasive method for operation in hypertensive intracerebral hemorrhage.Small bone flap craniotomy is a good choice for the treatment of hypertensive intracerebral hemorrhage.