高血压脑出血内外科规范化治疗的疗效比较——多中心随机前瞻性研究

The Randomized Multicentric Prospective Controlled Trial in the Standardized Treatment of Hypertensive Intracerebral Hematomas: The Comparison of Surgical Therapeutic Outcomes with Conservative Therapy

目的:评价高血压脑出血内、外科规范化治疗的疗效。方法:多中心前瞻性、随机对照比较内外科规范化治疗的效果。结果:外科组２６６例,内科组２３４例。按Ｌｏｇｉｓｔｉｃ模型统计,外科组近期和远期疗效明显优于内科组。外科组近期死亡率９．８%,远期死亡率１１．８%,并发症发生率均低于内科组。结论:高血压脑出血外科规范化治疗疗效优于内科规范化治疗。

Aim: To compare the efficacy between standardized surgical and conservative treatment in hypertensive intracerebral hematomas. Methods: A prospective controlled clinical study was conducted in 17 hospitals in Shanghai. All the patients were defined to surgical (266 cases ) or conservative group(234 cases )randomly. The statistic analysis was processed to compare the outcomes of each group. Results: The recent and long-term mortalities were 9.8% and 14.5% in surgical and conservative groups respectively ( P < 0.001), the percent of excellent and fine long-term outcomes were 67.3% and 57.8% in the surgical and conservative groups respectively (P<0.001). Conclusion: The surgical intervention is superior to the conservative treatment in hypertensive intracerebral hematomas.