小骨窗开颅手术治疗高血压脑出血62例分析

Small bone window craniotomy in 62 cases with hypertensive intracerebral hemorrhage

目的探讨小骨窗开颅血肿清除手术在高血压脑出血治疗中的应用。方法总结62进行该手术病例,探讨其适应证、手术时机、操作方法及预后。结果恢复良好9例,轻残23例,重残19例,植物生存1例,死亡10例(其中4例死于再出血)。结论该手术是一种在直视下简单、快捷、有效、损伤小的治疗高血压脑出血的方法。

Objective To explore the therapeutic efficacy of small bone window craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods Hypertension-induced intracerebral hematoma was cleaned up in 62 cases by means of small bone window craniotomy. The indications, operative time and techniques, prognosis were analyzed retrospectively. Results There was no death during the operation. 1~3 days later, the improvement of muscle power happened in 31 cases, conscious recovery in 31 cases; 3~4 days later, CT scan showed the hematoma was recovered almost in 23 cases; 50% in 13, 30% in 26; 56 cases had once a complete conscious recovery, of which 7 developed re-hemorrhage 3~7 days later. According to GOS, 9 cases had a good recovery, 23 ended with mild disabling, 19 with severe disabling, 1 with persistent vegetative state and 10 with death(4 from re-hemorrhage). Conclusion The small bone window craniotomy is an easy, speedy, effective way to deal with hypertensive intracerebral hemorrhage under straight view.