早期血肿穿刺吸引联合血肿清除去骨瓣减压术治疗高血压脑出血

Early hematoma piercing attract combining with hematoma clearance to bone valves decompression technique to treat high blood pressure brain hemorrhage

目的 探讨高血压脑出血的合理手术方式.方法 选择74例血肿量较大、颅内压较高的高血压脑出血患者,随机分为联合组及对照组,其中联合组患者实施早期血肿穿刺吸引联合血肿清除去骨瓣减压术治疗,对照组实施传统的血肿清除去骨瓣减压术治疗,对两组患者预后进行分析比较.结果 两组患者术后均随访6个月,联合组达到Ⅰ级5例,Ⅱ级12例,Ⅲ级15例,Ⅳ级1例,Ⅴ级1例;而对照组Ⅰ级4例,Ⅱ级11例,Ⅲ级13例,Ⅳ级8例,Ⅴ级4例.两组患者在ADL分级的差异有统计学意义（Wilcoxon W=1 253.000,P=0.005）结论 血肿量较大、颅内压较高的高血压脑出血患者,早期行血肿穿刺吸引联合血肿清除去骨瓣减压术是一种合理可行的手术方法,可改善该类患者预后.

Objective To explore hematoma piercing attract joint hematoma clearance to bone valves decompression technique in hematoma volume,skull,pressure high blood pressure brain hemorrhage treatment,and to further explore hypertension brain hemorrhage of reasonable surgery. Methods Hematoma in relatively large quantities of high intracranial pressure in hypertensive cerebral hemorrhage patients were randomly divided into experimental group and control group,and patients in the experimental group were implemented early hematoma puncture to attract a joint hematoma decompressive craniectomy treatment,and the control group were implemented the traditional hematoma de-compressive craniectomy treatment. The prognosis of the two groups were compared. Results The two groups were followed up for 6 months,and evaluated by ADL grade,between the two groups was statistically significant difference in ADL classification（ P〈0.01）. Conclusion In the hematoma volume larger, high intracranial pressure in hypertensive cerebral hemorrhage in the surgical treatment of patients,the early line to attract a joint hematoma puncture decompressive craniectomy was a reasonable and feasible surgical method which can improve these patients prognosis.