高血压脑出血规范化外科治疗的临床研究

The optimization of surgical treatment for hypertensive intracerebral hemorrhage

目的探讨传统内科治疗、早期骨瓣开颅手术和超早期小骨窗手术治疗高血压脑出血的临床效果。方法分析传统内科治疗高血压脑出血110例,与早期骨瓣开颅手术128例和超早期小骨窗手术350例治疗高血压脑出血及其病死率、预后、并发症和平均住院天数等方面的差异。结果超早期小骨窗手术组比传统内科治疗组和早期骨瓣开颅手术组在病死率、重残率、并发症和平均住院时间等均有一定的优势。结论超早期小骨窗手术方式可能是降低病死率,改善高血压脑出血病人预后的适宜手术方案。

Objective To explore the effects of conservative treatment, conventional craniotomy, and the ultraearly minimally invasive craniotomy on treating hypertensive intracerebral hemorrhage. Methods 588 patients with hypertensive intracerebral hemorrhage were treated with conservative treatment （110 cases）, conventional craniotomy （128 cases） and the ultra-early minimally invasive craniotomy （350 cases）, respectively. The fatality, prognosis, complications and the hospital days were analyzed. Results The method of ultra-early minimally invasive craniotomy demonstrated preponderance in fatality, prognosis, complications and the hospital days compared to that of the other two methods, including conservative treatment and conventional craniotomy. Conclusion The ultra-early minimally invasive craniotomy may be an appropriate surgical method to decrease the fatality and improve prognosis for hypertensive intracerebral hemorrhage.