ICU床旁微创术对中、重度高血压脑出血的救治研究

Treatment of severe hypertensive cerebral hemorrhage by micro-injury operation in ICU

目的 探索提高中、重度高血压脑出血救治成功率的新途径。方法 以 1998年 1月～ 2 0 0 1年 1月我科收治的 95例中、重度 (出血量 >30mL)高血压脑出血患者为研究对象 ,分为 3组 :内科治疗组 (Ⅰ组 ) 30例 ,外科开颅血肿清除术组(Ⅱ组 ) 32例 ,床旁微创颅内血肿清除组 (Ⅲ组 ) 33例 ,对比 3组间的治疗效果。结果 Ⅰ组 30例 ,死亡 19例 ,死亡率 6 3 3%。Ⅱ组 32例 ,死亡 17例 ,死亡率 5 3 1%。Ⅲ组 33例 ,死亡 7例 ,死亡率 2 1 2 %。出院 6个月随访总生活能力 (ADL) ,微创组ADL1-3 级明显优于其余两组 (P <0 0 1)。结论 ICU床旁早期微创颅内血肿清除治疗显著提高了中。

Objective To investigate the new method for elevating the survival rate of patients with severe hypertensive cerebral hemorrhage.Methods From Jan.1998 to Jan.2001,94 patients with hypertensive cerebral hemorrhage were treated in ICU,they were divided into 3groups:the 30 cases accepted no-surgical treatment in Ⅰgroup,the 31 cases accepted scavenging intracerebral hemorrhage in Ⅱ group,the 33 cases accepted micro-injury operation in Ⅲ group.Results Case-fatality rate was 63.3% in Ⅰgroup,craniotomy of 31 cases in Ⅱ group,case-fatality rate was 53.1%,33 cases were micro injury operation treatment in Ⅲgroup,case-fatality rate was 21.2%.All cases have been closely followed up for six months,the score of ADL in Ⅲ group is much higher than the other groups.Conclusions The bed side micro-injury operation for severe hypertensive cerebral hemorrhage in ICU significantly reduce the case-fatality rate.