超早期微创治疗高血压脑出血

Ultra-early minimally trauma surgery for hypertensive cerebral hemorrhage

目的 探讨超早期微创手术治疗高血压脑出血的疗效。方法 对162例符合高血压脑出血患者在发病后7h内采用锥颅置管血肿外引流术或小骨窗微侵袭开颅清除血肿术。结果 血肿全部清除50例,大部分清除112例;术后早期死亡15例（9.26%）。147例随访6-36月,前6月死亡6例。按ADL分级Ⅰ级30例（21.27%）,Ⅱ级40例（28.37%）,Ⅲ级42例（29.79%）,Ⅳ级20例（14.18%）,Ⅴ级9例（6.38%）。结论两种手术方法均创伤小,时间短,简单易行,死亡率低;术后神经功能恢复好且快。

Objective To discuss the effects of Ultra -early minimally trauma surgery treating hypertensive cerebral hemorrhage. Methods The intracerebral hematomas were evacuated by burr hole intubation or minimally invasive operation through small craniotomy within 7 hours after the hemorrhage in 162 patients with hypertensive cerebral hem- orrhage. Results The total evacuation of hematomas was achieved in 50 patients and subtotal in 112,15 patients died （9.26%）. Of 147 patients followed up from 6 to 36 months,6 died and 141 survived. According to ADL grading,of 141 survivors,30 were belonged in grade I ,40 in grade il ,42 in grade ll1,20 in grade IVand 9 in grade V. Conclusions The Ultra - early minimally trauma surgery for hypertensive cerebral hemorrhage has merits such as minimal opera- tive trauma, short operative time, simple and easy operative technique,low mortality and good recovery of neurobological function in the patients with hypertensive cerebral hemorrhage.