超早期微创开颅术治疗高血压脑出血

Therapy of hypertensive cerebral hemorrhage with small bone window craniotomy in super-early-stage

目的探讨超早期小骨窗开颅术治疗高血压脑出血的临床效果。方法1998年1月至2004年1月间33例高血压脑出血患者在头颅CT片指导下，均在发病后2～7h行小骨窗开颅手术治疗，行颞部直切口，小骨窗约3cm×3cm，血肿清除干净，活动性出血以电凝止血。结果存活26例，死亡7例，病死率（21．21％，7／33）。存活病例随访时间6个月～2年，平均1．2年。其中18例完全恢复，生活半自理6例，偏瘫2例，无植物生存。结论超早期小骨窗开颅术治疗高血压脑出血具有简便、有效等优点，是比较理想的治疗高血压脑出血的措施。

Objective To evaluate relrospectively the outcomes of the therapy of hypertensive cerebral hemorrhage with small bone window craniotomy in super - early - stage. Methods Thirty three patients suffered from hypertensive cerebral hemorrhage from January 1998 to January 2004 were received the therapy of small bone window craniotomy in the time of 2 - 6h after the cerebral haemorrhage under the direction of the patient＇s skull CT. The area of the bone window was olny 3.0cm × 3.0cm. The hematoma was completely sucked out. The active bleeding was stopped with electric coagulation. Results Of the 33 patients with hypertensive cerebral hemorrhage, 26 （78. 79% ）cases had been survived and 7（21.21% ）died. The 26 patients survived had been followed up from 6 months to 2 years （averaged 1.2 years ） ;18 cases had recovered completely ;6 cases could do semi -self- care ;2cases were in hemiplegia. No patient was in persistent vegetative state. Conclusions The small bone window craniotomy in super - early - stage is a simple,convenient,and effective method for the therapy of hypertensive cerebral hemorrhage.