高血压脑出血显微外科治疗

Microsurgical treatment of hypertensive intracerebral hemorrhage

目的分析显微手术治疗高血压脑出血的临床效果。方法对158例高血压脑出血患者中142例采用显微手术治疗,根据患者的出血部位、血肿体积及术中脑压情况,76例采用单纯彻底清除血肿,66例采用单纯清除血肿加去骨瓣压减术,并对两组治疗结果进行相关因素分析。结果两种手术治疗方法,患者恢复情况无显著性差异,丘脑出血、脑室内出血死亡率高、本组发病6h内手术无死亡率。结论高血压脑出血显微手术效果好,要根据患者的出血量、出血部位及术中的脑压选择术式。

Objective To investigate the clinical results of microsurgieal treatment on hypertensive intracerebral hemorrhage. Methods A total of 142 patients with hypertensive intracerebral hemorrhage were surgically treated under microscopy. Hematoma evacuation was performed in 76 cases and hematon~ removal combined with decompressive craniectomy was performed in 65 patients according to the site, volume and intracranial pressure in the operative procedure. Relative factors of two different treatment groups were analyzed statistically. Resets There was no difference in the recovery of patients between the two methods. Mortality in patients with thalamic hemorrhage and ventricular blood cast was higher than that of patients with hemorrhage in other sites. No death occurred postoperation within six hours after onset in this study. Conclusion Micmsurgery is a good method for treatment of hypertensive intracerebral hemorrhage. Departing bone flap or not is according to the hematona volume, site and intracranial pressure in the operative procedure.