个体化手术方式治疗基底节区高血压脑出血患者的疗效

目的 探讨个体化手术方式在治疗基底节区高血压脑出血中的疗效。方法 选取阜阳市第二人民医院2013年2月至2016年1月收治的32例基底节区高血压脑出血患者，根据患者年龄、血肿大小、意识情况及发病到手术的时间等，采用大骨瓣开颅血肿清除术、小骨窗显微手术和锥颅置管外引流术。结果 10例患者采用大骨瓣开颅血肿清除术，18例患者采用小骨窗显微手术，4例患者采用锥颅置管外引流术。术后随访半年，死亡1例，存活的患者根据日常生活能力分级法进行预后评价，Ⅰ级7例、Ⅱ级10例、Ⅲ级10例、Ⅳ级3例、Ⅴ级1例。结论 对基底节区高血压脑出血患者针对性采用个体化的手术方式，能有效提高患者生存率、改善预后。

Effects of individual selection of surgical modalities on hypertensive intracerebral hemorrhage

Objective To investigate the effect of individualized operation on hypertensive intracerebral hemorrhage in basal ganglia of patients. Methods Thirty-two patients with hypertensive intracerebral hemorrhage of basal ganglia treated by our department from Feb. 2013 to Jan. 2016 were divided into three groups according to age, individual condition, hematoma size, consciousness and time of onset to operation. Small bone window hematoma evacuation, traditional craniotomy and minimally invasive intracranial hematoma were chosen for appropriate group. Results 18 cases underwent microsurgery with small bone window, 10 cases with traditional craniotomy and 4 cases with minimally invasive intracranial hematoma. The patients were followed up for 6 months, 31 patients survived while 7 patients of them were in grade I, 10 in II, 10 in III, 3 in IV, and 1 in grade V, according to the ADL and 1 patient died. Conclusion The application of individualized operation on hypertensive intracerebral hemorrhage in basal ganglia of patients can improve the survival rate and the prognosis.