高血压性脑出血手术治疗与非手术治疗的疗效对比

A comparative study of operation and non-operation in treatment of hypertensive intracerebral hemorrhage(HICH)

目的对高血压病所致基底节区脑出血手术治疗与非手术治疗的临床疗效分析。方法 122例高血压性基底节区脑出血患者分为两组,A组68例,采用CT定位下颞部钻孔置管引流术联合药物治疗;B组54例采用药物非手术方式治疗。结果 122例治疗后除B组1例出院后4月再出血死亡外,其余121例患者均得到6个月以上随访。其中手术治疗组术后因出血量增加行开颅手术7例;非手术治疗子治疗期间因出血量增加行开颅手术4例。再出血发生率A组10.29%;B组7.40%,两组对比无显著差异(P>0.05);平均住院日A组11.36 d;B组24.50 d,两组对比有显著差异(P<0.01)。结论高血压性基底节区脑出血行钻钻孔置管引流+纤溶疗法手术治疗不明显增加再出血风险,对患者近期及远期疗效均有明显改善,是一种操作简单、安全、有效、经济的治疗手段。

Objective To study operation treatment of basilar hemorrhage caused by hypertension compared with non operation treatment.Methods 122 cases were randomly dividing into two groups according to with or without operation：group A and group B.Group A（operation group）had 68 cases and Group B（non operation group）had 54 cases.Group A were treated by drug and CT-assisted cranio-puncture and drainage,while Group B were treated by drug only.Results Among 122 cases,except for one case in group B had relapsing hemorrhage and dead,the others had interview over six months.Group A had 7 cases of craniotomy because of increasing hemorrhage,Group B had 4 cases of craniotomy.The rate of relapsing hemorrhage was 10.29% in Group A and 7.40% in Group B.There were no significant differences in relapsing hemorrhage between two groups（P0.05）.The average length of stay were 11.36 days in Group A and 24.50 days in Group B.There were significant differences in two groups（P0.01）.Conclusion CT-assisted cranio-puncture and drainage and dissolve the hematoma with urokinase,had not increased the risk of relapsing hemorrhage,and had more advantage in short and long-term efficacy.It is a kind of simple,safe,effective and economic treatment method for basilar hemorrhage caused by hypertension.