高血压脑出血45例手术治疗分析

Clinical analysis of minimally invasive therapy for hypertensive intracerebral hemorrhage in 45 Cases

目的探讨手术治疗对高血压脑出血的临床效果。方法对2006年5月至2007年6月收治的45例高血压脑出血患者的临床资料进行回顾性析。结果开颅手术17例,存活11例(64·70%),恢复良好6例(35·29%),中、重残7例(41·17%),死亡6例(35·29%);小骨窗开颅术28例,存活25例(89·28%),恢复良好20例(71·42%),中、重残7例(25%),死亡3例(10·71%)。小骨窗开颅术后,患者的存活率和恢复情况均高于开颅手术组,病死率明显低于开颅手术组。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,稳定颅内环境,阻断脑继发性损害,使脑组织得以修复,达到康复。手术治疗能明显地提高存活率,小骨窗开颅术优于开颅手术,既能提高存活率,又能较好地改善患者存活质量,是一种治疗高血压脑出血安全、及时、有效的手术方式。

Objective To compare clinical outcomes between craniotomy via small bone flap and conventional method for hypertensive intracerebral hemorrhage.Methods A total of 45 cases of hypertensive intracerebral hemorrhage received either craniotomy via small bone flap（n=17）or large bone flap（n=28）from May 2006 to June 2007 in this hospita1.Postoperative Outcomes between the two groups were compared.Results Both the survival and recovery rates of patients in small bone flap craniotomy group were significantly higher than that of large bone flap craniotomy group.However,the mortality of the small bone flap craniotomy group was significantly lower than that of the other group.Conclusion Application of craniotomy via small bone flap in the treatment of hypertensive intracerebral hemorrhage can give a much more satisfactory effect.