治疗高血压性脑出血的手术方式探讨：附70例报告

DISCUSSION OF OPERATIVE MODE USED IN THE TREATMENT OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE(Report of 70 cases)

In the past 4 years (1987-1991), we have treated 70 cases of hypertensive intracerebral hemorrhage with various operative modes tn place of osteoplastic craniotomy. This paper is to summerize our experiences and thereby to evaluate their clinical significance.According to patient's conditions we selectively adopted the following operative modes: small craniotomy; puncture of hematoma; stereotatic aspiration, infusion of urokinase into hematoma and ventricular drinage. Among 70 cases, 11 patients died of postoperative complications. The mortality rate was 15.7%. The funtional outcomes for 6 months after hamorrhage were as follows; 27.2% excellent, 37.4% good, 15.2% fair, 10.2% poor, 5% dead and 5% unknown.From above data we may conclude; ( 1 ) there operative modes are simple, effective and safe, especially for eldirly and highrisk patients, (2) op-ration time is shortened, ( 3 ) less trauma to the brain tissue, ( 4 ) the use of local anesthesia minimizes anesthtic complications, maintains patient's conciousncss, facilitates nursing care an'd early recovery, ( 5 ) as compared with similar patient group previously operated by traditionr.1 osteoplastic craniotomy, these operative modes obviously produced better clinical results.The choice of operative mode as to the duration of hemorrhage, the indication of each operative mode, and the indication of surgical intervention as relatod to the amount of hemorrhage are fully discussed in this paper