高血压脑出血超早期患者手术方式和术后再出血的关系

目的研究高血压脑出血超早期手术患者骨瓣开颅血肿清除术和微创硬通道穿刺血肿抽吸引流术与术后再出血的关系。方法选择高血压脑出血超早期手术患者258例,其中185例采用骨瓣开颅血肿清除术(开颅组),73例采用微创硬通道穿刺血肿抽吸引流术(微创组),对比2组的术后再出血发生率。结果 2组患者在年龄、性别、术前格拉斯哥昏迷评分、术前血肿量、术后血压的波动和是否有阿司匹林服用史方面比较,差异无统计学意义(P>0.05),开颅组术后再出血率较微创组明显降低,差异有统计学意义(5.9%vs 13.7%,P<0.05)。结论超早期高血压脑出血患者骨瓣开颅血肿清除术治疗较微创硬通道穿刺血肿抽吸引流术可明显降低再出血率。

Relation between surgical methods and rebleeding in ultra-early hypertensive intracerebral hemorrhage patients

Objective To study the relation of hematoma removal craniotomy with bone flap and aspiration drainage by microtraumatic hematoma hardpassage puncture with postoperative rebleeding in ultra-early hypertensive intracerebral hemorrhage patients.Methods Two hundred and fifty-eight ultra-early hypertensive intracerebral hemorrhage patients were divided into craniotomy group(n=185) and microtrauma group(n= 73).Patients in craniotomy group underwent hematoma removal craniotomy with bone flap and those in microtrauma group underwent aspiration drainage by microtraumatic hematoma hardpassage puncture.Incidence of rebleeding was compared between the two groups after operation.Results No significant difference was found in the age,gender,preoperative GCS score,hematoma volume,postoperative blood pressure fluctuation, and aspirin use history between the two groups(P>0.05).The rebleeding rate was significantly lower in craniotomy group than in microtrauma group(5.9%vs 13.7%,P<0.05).Conclusion The rebleeding rate is significantly lower in ultra-early hypertensive intracerebral hemorrhage patients after hematoma removal craniotomy with bone flap than after aspiration drainage by microtraumatic hematoma hardpassage puncture.