超早期微创穿刺急进型高血压脑出血临床分析

目的探讨对急进型高血压脑出血患者在超早期进行微创外科治疗的可能性。方法回顾分析2001年6月至2005年7月36例急进型高血压脑出血患者的临床症状影像学特点。对全部病例在发病6h内行微创脑内血肿清除术,其中11例在发病后48h内行第2次脑内血肿穿刺,6例在第1次手术后效果不佳而由家属选择改行开颅血肿清除术。另有8例因合并脑室内较多出血同时行脑室穿刺外引流术。结果随访6个月至1年,日常生活行为(ADL)Ⅱ级1例,ADLⅢ级9例,ADLⅣ级7例,ADLⅤ3例,死亡11例。另有5例手术后7～28d由家属放弃治疗,自动出院。结论根据急进型高血压脑出血患者的不同特点,选择适宜的外科治疗,可以提高这一部分患者的预后结果,为进一步的处理赢得时间。

Surgical treatment of aggressive hypertensive intracerebral hemorrhage at the super-early stage

Objective To explore rhe possibility of the surgical treatment for aggressive hypertensive intracerebral hemorrhage（HIH）at the super-early stage.Methods The clinical data of 36 HIH patients from Jun.2001 to July.2005,including their clinical pathologic and image characteristics,were retrospectively analyzed.All cases were performed with minimally invasive intracerebral hematoma evacuation within 6 hours of attack,including 11 cases were performed with secondary intracerebral hematoma puncture 48 hours later.Other 8 cases of the intraventriclar bleeding were applied with same way for external drainage.Results 31cases were followed up about 6 months to one year：ADL（activity of daily living）,and there were 1 case of ADL II,9 cases of ADL III,7 cases of ADL IV,3 cases of ADL V and 11 cases of death.And the other 5 cases gave up treatment and automatically were discharged out of the hospital.Conclusion According to the different characters of the patients,we would choose the proper surgical treatment and gain the good final results.