高血压脑出血的微侵袭手术治疗——前瞻随机多中心研究

Minimally Invasive Surgery for Hypertensive Hematomas——A Prospective Randomized Multiple Centers Trial

目的 :比较高血压脑出血微侵袭手术治疗的疗效。方法 :11个医院应用前瞻、随机、对照的研究方法 ,内科组 10 5例 ,微侵袭外科组 14 4例 ,比较高血压脑出血内科治疗与微侵袭外科治疗近期 (1个月 )和远期随访 (6个月 )。结果 :近期疗效外科组明显好于内科组 (P <0 0 0 1) ;近期死亡率在两组间无差别 :内科组近期死亡 12例 ,死亡率 11 4% ,外科组近期死亡 13例 ,死亡率 9 0 % (P =0 471)。远期疗效外科组明显好于内科组 (P =0 0 0 6) ;远期死亡率外科组低于内科组 :内科组远期死亡 7例 ,死亡率 7 5 % ,外科组远期死亡 4例 ,死亡率 3 1% (P =0 0 13 )。结论

Aim:To study the effects of minimally invasive operations on hypertensive intracerebral hematoma.Methods:This is a prospective and randomized study. Data were gathered from 11 hospitals. 105 cases were treated conservatively, and 144 cases were operated. The follow up one and six months after hospitalization were compared.Results:Surgery group had a better one month follow up than the conservative group ( P <0 001),while the one month death rate had no difference (12 cases and 11.4% in conservative group versus 13 cases and 9.0% in surgery group). Surgery group also had a better six months follow up than conservative group( P =0 006),while the six months death rate was also lower in the surgery group (4 cases,3.1% in surgery group versus 7 cases and 7.5% in conservative group, P =0 013).Conclusion:Minimally invasive srugery is an effective treatment of hypertensive intracerebral hematoma.