小骨窗显微手术治疗基底节区高血压脑出血的预后相关因素分析及疗效观察

Analysis of prognosis related factors in small bone window microsurgery treatment for hypertensive intracerebral hemorrhage in basal ganglia and observation its therapeutic effect

目的观察小骨窗显微手术治疗基底节区高血压脑出血的疗效并分析其预后相关因素。方法选择2010年5月至2012年5月治疗的基底节区高血压脑出血患者64例,均采用小骨窗显微手术。采用日常生活能力(ADL)分级法评定预后并探讨其影响因素。结果 64例患者中,死亡4例,病死率为6.25%;ADL分级法评定其患者预后,优秀率为73.4%。单因素分析显示,手术时机、血肿量、血肿位置是影响高血压脑出血预后的因素(P<0.05)。结论小骨窗开颅显微手术具有视野清晰、减压充分、出血量少、创伤轻微的优点,早期手术、血肿量小、血肿位置为内囊前肢型及外囊型者预后较佳。

Objective To analyze prognosis related factors of small bone window microsurgery treatment for hypertensive intracerebral hemorrhage in basal ganglia and observe its therapeutic effect. Methods Sixty four cases of patients with hypertensive intracerebral hemorrhage treated in our hospital from May 2010 to May 2012 were included into this study. All patients were performed small bone window microsurgery treatment. ADL scalable mode was used to evaluate prognosis. The related factors were discussed. Results Among 64 cases of patients, 4 cases were dead, the fatality rate was 6.25%. The excellent rate of prognosis was 73.4% by ADL evaluation. Single factor analysis showed that opera- tive opportunity, hematoma quantity and hematoma position were related highly with the prognosis of hypertensive intracerebral hemorrhage. Conclusion Small bone window microsurgery has the advantages of clear vision, decompression fully, less amount of bleeding and slight trauma. The prognosis of patients with early operation, less hematoma quantity, anterior limb of internal capsule type and external capsule type is good.