超早期手术治疗重症幕上高血压脑出血43例临床分析

Early Surgical Treatment of Severe Hypertensive Cerebral Hemorrhage (With 43 clinical Cases analysis)

目的:探讨重症幕上高血压脑出血超早期手术治疗方法的临床疗效。方法:对43例重症高血压脑出血患者早期开颅血肿清除加硬膜减张缝合去骨瓣减压术回顾分析。结果:患者术后死亡7例,存活36例,生存率83.7%。随访0.5～2年,根据ADL(日常生活能力)分级法Ⅰ～Ⅲ级良好率60.46%。结论:对重症高血压脑出血患者行超早期开颅血肿清除加硬膜减张缝合去骨瓣减压术手术治疗能够降低病死率,提高存活率。

Objective：To explore the early surgical treatment for severe hypertensive cerebral hemorrhage.Methods：43 cases of severe hypertensive cerebral hemorrhage were treated with open evacuation of hypertensive intracerebral hemorrhage,dural relaxation suture and decompressive craniectomy within 7 hours.Results：Of the 43 patients with early surgical treatment,7（16.3%） died after operation,36（83.7%） survived to discharge;By the following-up from 0.5 to 2 year,the ability of daily life（ADL） scale recovered to the levelⅠwith 4 cases,the level Ⅱ with 8 cases,the level Ⅲ with 14 cases,the level Ⅳ with 7 cases,the level Ⅴ with 3 cases;26（60.46%）made a good recovery（the levelⅠ-Ⅲ）.Conclusion：Early hematoma evacuation,dural relaxation suture and decompressive craniectomy are effective treatment for severe hypertensive cerebral hemorrhage.It is of great significance in reducing the mortality rate and improving quality of life.