老年人高血压脑出血的外科治疗

目的：评估老年人高血压脑出血的外科治疗效果，并寻找最佳治疗方案。方法：研究７０例老年人高血压脑出血的外科治疗，其中３５例行立体定向抽吸术，３５例行开颅术。另外７０例非手术保守治疗病人作为对照。所有结果经统计学分析。结果：立体定向组和开颅手术组的死亡率低于保守治疗组（Ｐ＜０．０５）。立体定向组和开颅手术组的ＡＤＬ相近，但高于保守治疗组（Ｐ＜０．０５）。结论：年龄不是决定是否手术的主要指标，手术应是老年人高血压脑出血的重要治疗手段之一。同时还对ＧＣＳ评分、手术时机、手术方法、出血量、血肿的部位与预后、术后再出血等进行了讨论。

SURGICAL TREATMENT FOR THE ELDER HYPERTENSIVE INTRACEREBRAL HEMORRHAGE

Objective:To evaluate the effect of the surgical therapies for the elder hypertensive intracerebral hemorrhage,and search for the best treatment for it.Method:70 cases of the elder hypertensive intracerebral hemorrhage have been studied,35 of them have been treated by stereotactic operation,35 by craniotomy.another 70 non-operative cases to be contrasted.All results were analyzed with statistical test.Result:Death rate of the stereotactic operation and craniotomy is lower than that of non-operative group (P<0.05).ADL of stereotactic operation is similar to that of craniotomy,which is higher than non-operative group (P<0.05).Conclusion:Age should not be the most important indication for surgical therapy,and operation should be one of the most important treatment for the elder hypertensive intracerebral hemorrhage.The relationship between GCS,time of operation,method of operation,amount of hemorrhage,site of hemorrhage and prognosis,post-operation hemorrhage have also been discused.