高血压脑出血破入脑室手术时机和手术方式对病情转归的影响

目的探讨高血压脑出血破入脑室不同手术时机和手术方式对病情转归的影响。方法采用回顾性分析的方法,选择了185例不同手术时机（〈7 h7、h-48 h,〉48 h）,3种治疗手段即常规开颅血肿清除术、脑室外引流辅助尿激酶灌注结合腰穿脑脊液置换治疗、单纯腰椎穿刺治疗的高血压脑出血破入脑室患者,进行死亡率、预后情况比较分析。结果病情转归（ADL1和ADL2）〈7 h者,较7 h-48 h7、h-48 h较〉48 h者良好（P〈0.05）,有显著差异;3种不同治疗手段脑室外引流组死亡率最低,开颅血肿清除术组次之,单纯腰椎穿刺治疗组最高,3者相比P〈0.05。结论高血压脑出血手术时机超早期好于早期,早期又好于延期,治疗手段脑室外引流好于常规开颅血肿清除术、常规开颅血肿清除术好于单纯腰椎穿刺治疗。

Effect on Prognosis of Operative Time and Method for Leakage into Ventricle for Hypertension Cerebral Hemorrhage Patient

Objective To discuss the effect on prognosis of operative time and method for leakage into ventricle for hypertension cerebral hemorrhage.Methods 185 cases of such patient were analyzed in varied operative time(within 7 h,7～48 h and over 48 h) and three different methods (routine remove of hematoma,extra-ventricle drainage with urokinase perfusion and CSF replacement and single lumbar puncture) in mortality and prognosis.Results ADL1 and ADL2 within 7h were better than those in other two groups with P<0.05.The effect of method was better in second group,then first and last with P<0.05.Conclusion The early therapy of such patient might have better effect as well as extra-ventricle drainage and then hematoma remove.