高血压脑出血69例手术治疗临床分析

Clinical analysis of surgical treatment of 69 cases of hypertensive cerebral hemorrhage.

目的探讨手术治疗对高血压脑出血的临床效果。方法对我科收治的69例高血压脑出血患者的临床资料进行回顾性分析。结果本组69例,开颅手术31例(44.93%),存活20例(64.52%),其中恢复良好6例(30.00%),中、重残12例(60.00%),植物生存2例(10.00%),死亡11例(35.48%);采用YL-1型颅内血肿微创穿刺粉碎引流术38例(55.07%),存活32例(84.21%),其中恢复良好23例(71.88%),中、重残9例(28.13%),死亡6例(15.79%)。本组总死亡17例(24.64%)。结论高血压脑出血外科治疗能及时针对病因清除血肿,消除占位,制止出血,降低颅内高压,稳定颅内内环境,阻断脑继发性损害,使病损的脑组织得以修复,达到康复。手术治疗能明显地提高存活率,YL-1型颅内血肿微创穿刺粉碎引流术治疗要比开颅手术为优,采用YL-1型颅内血肿微创穿刺粉碎引流术治疗既能提高存活率,又能大大提高存活质量,是一种治疗高血压脑出血安全、及时、效好的术式。

Objective To investigate the clinical results of surgical treatment of hypertensive cerebral hemorrhage. Methods The clinical data of 69 eases of hypertensive cerebral hemorrhage were retrospectively analyzed. Results 31 cases underwent eraniotomy（44.93%） ,in whom 20 cases survived（64.52% ） ,6 of whom obtained better recovery（30.00%） , 12 of whom were moderately or severely disabled（60.00%） ,2 of whom presented plant survival status （ 10.00% ） and 11 cases died （ 35.48% ） ; 38 cases experienced YL-1 drainage of intracerebral hematoma （55.07%） ,in whom 32 eases survived（84.21%） ,23 of whom obtained better recovery（71.88% ） ,9 of whom were moderately or severely disabled（28.13% ） and 6 cases died（ 15.79% ）. 17 cases died in 69 cases（24.64% ）. Conclusion Surgical treatment of hypertensive cerebral hemorrhage can timely remove hemotoma,eliminate occupaying, prevent bleeding, lower intracerebral hypertension, stabilize the intracerebral internal environment, block cerebral secondary damage so that the damaged cerebral tissue is able to be repaired. Surgical treatment can significantly increase the survival rate. YL-1 drainage is superior to craniotomy,whieh can not only increase the survival rate but also the living quality, so it is a safe and effective operation method for hypertensive cerebral hemorrhage.