高血压性脑出血术式及手术时机的选择

目的探讨高血压性脑出血(HICH)术式及手术时机的选择。方法对2000年1月～2011年12月我院收治的625例高血压脑出血患者的手术治疗效果进行回顾性分析。结果高血压性脑出血患者发病至手术时间<6 h组手术再出血率显著高于6～24 h组与>24 h组。颅骨钻孔尿激酶溶解引流术死亡率低于小骨窗开颅术及骨瓣开颅血肿清除术,且临床疗效较好,与其他两种术式比较,差异有统计学意义(P<0.05)。结论 HICH患者应于出血后6～24 h选择合理手术方式进行手术治疗。

Choice of operation type and time for hypertensive intracerebral hemorrhage

Objective To discuss the choice of operation type and time for hypertensive intracerebral hemorrhage （HICH）. Methods Surgical treatment effects of 625 cases of patients with HICH from January 2000 to December 2011 were ana- lyzed retrospectively. Results The re-bleeding rate of HICH patients with disease to operation time 〈 6 h was higher than 6-24 h group and 〉 24 h group. The mortality rate of patients with skull drilling urokinase dissolved drainage was lower than those with small bone window craniotomy and bone flap craniotomy evacuation of hematoma, and its clinical efficacy was better than other groups, the difference was statistically significant （P 〈 0.05）. Conclusion The operation should be carried out with proper selection of operation type after bleeding 6 to 24 h for HICH patients.