老年人高血压脑出血外科治疗的探讨

Surgerg in Hypertensive Intracerebral Hemotoma in Old People

目的：分析老年人高血压脑出血临床特点，探讨其外科治疗的预后。方法：采用局麻下小骨窗开颅血肿清除术、尿激酶引流术、ＣＴ引导立体定向血肿排空术，以此３种术式治疗老年人高血压脑出血１７９例，并与同期手术１３６例非老年患者进行比较。结果：经６个月～１１年随访，老年组ＡＤＬ１－３级１３８例（７７．１％），死亡４１例（２２．９％）；非老年组ＡＤＬ１－３级分别为１００例（７６．１％）及２８例（２１．８％），两组差异无显著性（χ２检验Ｐ值＞０．０５）。结论：年龄不再是决定手术与否的主要条件，关键是加强对术后并发ＭＯＦ（多脏器衰竭）及早防治才有效。

Objective:In order to analgsis the clinin features of the hypertensive intracerebral hemotoma in old people,and to observe the prognosis of surgical treatment.Methods:We use three methods (Local-anaesthasia,small bone window,evacuation of hemotoma;CT-guided stereotectic surgery;Wrokinase drawing)to care 179 cases hypertensive hemotoma in old people,and compare with 136 cases operated non-old people with hypertensive hemotoma at the same period.Results:After followed up 6 months to 11 years,we find that in old people group,ADL1-3 degree are 138 cases (77.1%),41 cases died(22.9%);in non-old people group ADL1-3 degree are 100 cases (76.1%),28 cases died(21.8%).After χ2 test we find that the difference between the two group in no meaning(P>0.05).Conclusion:Age is not the main factor to decide whether operation is necessary,and it is effective to prevent the MOF after operation.So we can rise the live quality.