高血压脑出血手术治疗的临床研究

目的探讨高血压脑出血手术治疗的效果。方法回顾性分析208例高血压脑出血手术治疗患者的资料,其中行开颅血肿清除术加去骨瓣减压术35例,直切口小骨窗开颅血肿清除术36例,微创血肿引流术137例。观察比较三组患者手术疗效并与入院时GCS评分,出血量,手术时机的关系。结果患者入院时GCS评分越高预后越好,血肿量较小者预后较好,患者在6h内及6~24h内手术较24h后手术预后好。三组术式患者近期疗效指标(术后2周GOS评分)和远期疗效(术后3月ADL评分)无显著性差异。结论GCS评分可用于判断HICH的严重程度和估计预后,超早期或早期手术能降低病死率,提高手术疗效,不同的血肿量决定了患者的不同预后,不同的手术方法对预后无显著性差异。

The Clinical Study on Surgery Treatment for Hypertensive Intracerebral Hemorrhage

Objective To observe the effect of surgical treatment for patients with hypertensive intracerebral hemorrhage(HICH).Methods 208 HICH patients treated by surgery were retrospective analysed.Among these cases,35 patients were treated with hematoma evacuation plus decompresive craniectomy,another 36 cases with craniectomy and hematoma evacuation and the other 137 with burr hole evacuation and drainage.Datum of these patients such as GCS score,hematoma volume,interval between ictus and surgery and outcome were analysed.Results Higher GCS score,smaller hematoma volume,and earlier surgical intervention were good predictors of outcome.There was no statistically difference in both short term(GCS,2 weeks after surgery) and long term outcome(ADL scores,3 months after surgery) among these different surgical treatments.Conclusions For HICH patients with high GCS score and small hematoma volume early surgery could achieve good outcome,no matter what kind of surgical method is performed.