两种手术方式治疗高血压脑出血的疗效比较

目的比较小骨窗显微镜下手术及CT引导血肿吸引治疗高血压基底节区出血的疗效。方法回顾性分析110例高血压基底节区出血的临床表现、手术方式及疗效。结果小骨窗显微镜下手术58例,CT引导血肿吸引52例。2组年龄、术前血压、血肿量、术前GCS评分及发病至手术时间均无明显差异(P>0.05)。血肿清除量:小骨窗组优于血肿吸引组(P<0.01);术后48h意识好转率小骨窗组(77.6%)高于血肿吸引组(65.4%),差异有显著性(P<0.05);再次出血率,CT引导血肿吸引组高于小骨窗显微镜下手术组(P<0.05)。结论小骨窗显微镜下手术清除血肿充分、止血彻底,疗效优于CT引导血肿吸引术。

Comparison of the effects of two different surgical treatments for hypertensive cerebral hemorrhage in the area of basal ganglion

Objective To compare the effect of microsurgical treatment through a small skull window with that of computed tomographic-guided aspiration for hypertensive cerebral hemorrhage in the area of basal ganglion. Methods The clinical manifestation, operation and prognosis of 110 cases of hypertensive cerebral hemorrhage in the area of basal ganglion were analyzed retrospectively. Results The number of microsurgical treatment through a small skull window and computed tomographic-guided aspiration were 58 and 52 respectively. There were no differences in age, blood pressure before operation, size of hematoma, GCS score and time interval before operation of the two groups(P>0.05). Hematoma was evacuated more thoroughly with the operation of microsurgical treatment through a small skull window than that with computed tomographic-guided aspiration(P<0.01). The consciousness state elevated for 77.6% patients with the operation of microsurgical treatment through a small skull window and 65.4% patients with computed tomographic-guided aspiration 48 hours after operation (P<0.05). The rehemorrhage rate of the patients with microsurgical treatment through a small skull window was lower than that of the patients with computed tomographic-guided aspiration (P<0.05). Conclusion The effect of microsurgery through a small skull window is more satisfactory than that of computed tomographic-guided aspiration. Hematoma could be enough evacuated and exact hemostasis could be achieved with microsurgery through a small skull window.