高血压脑出血早期凝血功能异常患者不同手术方式疗效比较

目的探讨高血压脑出血（HICH）早期凝血功能异常患者不同手术方式的选择及疗效差异。方法回顾性分析早期发现凝血功能异常的65例脑出血手术患者，根据术式不同分为小骨窗血肿清除引流组（小骨窗组，38例）与微创穿刺碎吸引流组（微创组，27例），计算两组间血肿再发率、恢复率、重残率与病死率，并进行对比分析。结果微创组血肿再发、重残及死亡发生率（14．8％、22.2％、7．4％）均明显低于小骨窗组（39．5％、31.6％、23．7％），差异均有统计学意义（均P〈0．05），而恢复率（70.4％）则明显高于小骨窗组（44.7％），差异亦有统计学意义（P〈0．05）。结论对于HICH早期凝血功能异常的患者，采取微创穿刺碎吸合并尿激酶冲洗引流简捷、创伤小，可有效减少二次血肿的发生，有利于改善患者预后。

Therapeutic effect of different surgical modalities for hypertensive intracranial hemorrhage with blood coagulation defect at early stage

Objective To investigate the therapeutic effect of various surgical treatment for hypertensive intracranial hemorrhage(HICH) with blood coagulation defect at the early stage. Methods Sixty five HICH patients with blood coagulation defect at the early stage were treated with drainage with craniotomy and clearance of hematoma (group A, n=38) or drainage with minimally invasive puncture (group B, n=37), respectively. The incidence rate of secondary hematoma, recovery rate, disability rate and mortality rate we...