两种不同手术方法治疗高血压脑出血的疗效观察

Curative effect observation of two different operative approaches for the treatment of hypertensive intracerebral hemorrhage

目的观察开颅清除血肿和穿刺引流血肿两种手术方法治疗高血压脑出血的疗效。方法23例行开颅血肿清除(2例行单纯开颅血肿清除术,21例行开颅血肿清除+去骨瓣减压术),37例行穿刺引流血肿(3例行一侧脑室穿刺引流,10例行血肿加脑室穿刺引流,11例行血肿穿刺引流,13例行双侧脑室穿刺引流)。结果开颅清除血肿和穿刺引流血肿术后生存率分别为70%和78.4%,平均住院时间分别为28.6d和24.8d。结论开颅清除血肿和穿刺引流血肿均是治疗高血压脑出血的有效方法,术前可以根据患者的情况,选择其中一种手术方法。

Objective To oberserve the curative effect of two different operative approaches-evacution of hemotoma by craniotomy or by puncture and drainage-for the treatment of hypertensive intracerebral hemorrhage. Methods Evacutaion of hemotoma by craniotomy was performed in 23 cases （ simple evacution of hemotoma by craniotomy in 2, evacution of hemotoma by craniotomy ＋ bone flap depression in 21 ）. Evacuation of hemotoma by puncture and drainage was performed in 37（ puncture and drainage of one side ventricle in 3, hematoma ＋ ventricle in 10, hemotoma in 11 and both sides ventricle in 13 ）. Rusults The survival rate of two different methods was 70% and 78.4% separately. The average time of hospitalization was 26. 6 and 24.8 days. Conclusions Evacution of hemotoma by craniotomy or by puncture and drainage for the treatment of hypertensive intracerebral hemorrhage are two different effective ways. You may chose either way according to the patient＇ s preoperative situation.