高血压脑出血破入脑室不同手术方法疗效比较

A prospective randomized study of surgical treatment of hypertensive intracerebral hemorrhage rupturing into the lateral ventricle

目的：探讨高血压脑出血破入脑室的外科治疗方法。方法：采用骨瓣减压血肿清除术（２７例）和小骨窗血肿部分清除术结合重组链激酶溶解血肿治疗（２１例）进行对照研究。结果：２组近期疗效无明显差异，远期疗效骨窗组优良率（４１．２％）高于骨瓣组（１１．１％）。结论：微创、减压和纤溶药物的应用是高血压脑出血破入脑室的较佳的外科治疗方法。

Objective :To evaluate surgical treatment of hypertensive intracerebral hemorrhage rupturing into the lateral ventricle. Methods :In a prospective study,48 patients with hypertensive intracerebral hemorrhage (ICH) which ruptured into the lateral ventricle were randomly assigned to receive craniotomy or small bur hole surgery combined recombinant streptokinase. Results :The overall mortality rate within one month was 271%.It seemed that there were more patients died in the craniotomy group but the difference was not statistically significant.In the follow up,more patients in the bur hole group showed good recovery. Conclusions :This study suggests that minimal invasive surgical treatment of this category of patients with ICH does offer some advantage over craniotomy.