56例高血压脑出血手术治疗体会

Surgical treatment for hypertensive intracerebral hemorrhage:Experience of 56 cases

目的:探讨高血压脑出血个体化手术治疗方案的选择和疗效。方法:对需要外科手术治疗的56例高血压脑出血患者,遵循个体化的原则,根据出血部位、血肿量、发病时间、意识状态等进行综合分析,采用常规骨瓣开颅、小骨窗开颅、锥颅血肿抽吸等手术方式进行治疗。结果:存活45例,死亡11例。随访3～6个月,根据ADL分级法判断:Ⅰ级9例、Ⅱ级15例、Ⅲ级12例、Ⅳ级5例、Ⅴ级4例。结论:高血压脑出血手术患者,术前要综合分析病情,采取个体化手术方案,灵活机动地选择手术方法,可以取得良好的治疗效果。

Objective ： To assess the efficacy of surgical treatment of hy- pertensive cerebral hemorrhage by individualized protocol. Methods： On individualized basis of bleeding site, hematoma valume, onset time and state of consciousness,56 patients with hypertensive intracerebral hemorrhage required surgical treatment underwent conventional craniotomy, or small bone window craniotomy, or stereotaxic aspiration. Results ： Of the 56 patients, 45 survived and 11 died. Follow up was between 3 and 6 months,and the findings by Activity of Daily Living Scale（ADL） showed that 9 were in grade I ,15 in grade II,12 in grade III ,5 in grade IV and 4 in grade V. Conclusion ： For hypertensive patients with cerebral hemorrhage, comprehensive preoperative consideration of the conditions with individualized surgical options can lead to better curative outcomes.