超早期小骨窗微侵袭手术治疗高血压脑出血

Ultra-early Minimally Invasive Surgery through Small Craniotomy for Hypertensive Cerebral Hemorrhage

目的探讨超早期小骨窗微侵袭手术治疗高血压脑出血的疗效。方法对183例符合纳入标准的高血压脑出血患者在发病后7h内采用小骨窗微侵袭开颅手术清除血肿。结果血肿全部清除156例,大部分清除27例;术后早期死亡16例(8.74%)。167例随访6￣48月,随访前6个月死亡5例。按ADL分级Ⅰ级33例,Ⅱ级50例,Ⅲ级54例,Ⅳ级23例,Ⅴ级2例。结论该手术创伤小、时间短、简单易行,死亡率低,术后神经功能恢复好且快。

Objective To explore the curative effects of ultra-early minimally invasive surgery through small craniotomy on hypertensive cerebral hemorrhage. Method The intracerebral hematomas were evacuated by minimally invasive operation through small craniotomy within 7 hours after the hemorrhage in 183 patients with hypertensive cerebral hemorrhage. Results The total evacuation of hematomas was achieved in 156 patients and subtotal in 27. Sixteen patients died （8.74%）. Of 167 patients followed up from 6 to 48 months, 5 died and 162 survived. According to ADL grading, of 162 survivors, 33 was belonged in grade Ⅰ, 50 in grade Ⅱ, 54 in grade Ⅲ, 23 in grade Ⅳ and 2 in grade Ⅴ. Conclusions The minimally invasive surgery through small craniotomy for hypertensive cerebral hemorrhage has merits such as minimal operative trauma, short operative time, simple and easy operative technique, low mortality and good recovery of neurological function in the patients with hypertensive cerebral hemorrhage.