立体定向微创血肿碎吸术治疗高血压脑出血33例临床分析

Treatment of hypertensive cerebral hemorrhase by micro-invasive stereotaxis technique： clinical analysis of 33 cues

目的 探讨立体定向微创血肿碎吸术治疗高血压脑出血的手术时机。方法回顾性分析33例我院立体定向血肿碎吸术治疗高血压脑出血患者的临床资料，了解不同时间段手术与临床疗效之间的关系。结果立体定向微创血肿碎吸术治疗高血压脑出血的手术时间最好是发病后6～24小时，发病后6小时内手术者术中术后再出血发生率高，发病24小时后手术者神经功能后遗症较重。结论高血压脑出血行立体定向微创血肿碎吸术具有创伤小、康复快、并发症少等优点，手术时机以发病后6—24小时为佳，血肿量超过60ml也并非手术禁忌症。

Objective To investigate operation time of hypertensive cerebral hemorrhage drawed by minimally Invasive stereotaxis technique, Methods 33 patients, with hypertensive cerebral hemorrhage drawed by minimally invasive stereotaxis technique, were analyzed retrospectively, and divided into several groups by operation time, and investigated the relation of the groups with treatment outcome, Results The better operation time of drawed by minimally invasive stereotaxis technique was 6-24 hours after hypertensive cerebral hemorrhage. The incidence of rehaemorrhagia was very high when patients with hypertensive cerebral hemorrhage were operated by stereotaxis in 6 hour, however, the prognosis of patients operated during 6-24 hours was efficient, with lower incidence of rehaemorrhagia, neurologic residual and complication, the serious residual would be remained after 24 hours when operation.Conclusions More advantages were produced by stereotaxis technique to hypertensive cerebral hemorrhage, which was profitable for trauma, rehabilitation and complication, and the optimal time was 6-24 hours after hypertensive cerebral hemorrhage, and the patient which volume of hematoma in excess of 60ml can be operated, especially.