高血压基底节区出血手术方式探讨

Evaluation of Operative Approaches in Treatment of Hypertensive Intracerebral Hemorrhage

目的:探讨高血压脑出血的手术方法。方法:分析65例高血压脑出血患者的手术治疗方法。结果:采用常规开颅32例、小骨窗22例,显微镜下清除血肿、止血;采用CT引导下血肿碎吸术11例。随访4～6个月,ALD评定为Ⅰ级13例,Ⅱ级22例,Ⅲ级15例,Ⅳ级7例,Ⅵ级8例,死亡率12.31%。结论:高血压脑出血手术方式的选择应有利于有效降低颅内压、获得最大程度神经功能恢复,结合有无基础疾病,从患者具体情况出发,恰当选择。

Objective： To investigate operative approache in treatment of hypertensive intracerebral hemorrhage. Methods： Sixty -five cases with basal ganglion hemorrhage treated with operation were analyzed. Tirty -two cases were treated with conventional craniotomy and 22 cases with key -hole approach. Hematoma evacuation and hematoma cavity hemostasis were performed with microsurgical treatment. Eleven cases were treated with computed tomography guided aspiration. Different approaches were evaluated. Results： 4 -6 months after operation, activity of daily life of 13 cases was in grade 1,22 in grade 2, 15 in grade 3,7 in grade 4, 8 in grade 5. The mortality was 12.31%. Conclusion： The optimum treatment for hypertensive intracerebral hemorrhage should be in favor of the utility of intraeranial pressure depression, the ideal nervous system functional recovery, the quality of health level, individualization design.