高血压性脑出血外科治疗方式和影响疗效因素

Surgical treatment method and curative effect influencing factors of hypertensive cerebral hemorrhage

目的 探讨高血压性脑出血外科治疗方式的优劣以及影响疗效的因素。方法 60例在外科接受治疗的高血压性脑出血患者,随机分为开颅组（开颅血肿清除术）和引流组（钻孔血肿引流术）,每组30例。两组患者均在发病后的3~72 h之内进行手术治疗,其中超早期治疗（6~7 h）25例,7 h以上接受手术治疗35例。结果 开颅组和引流组的格拉斯哥预后评分（GOS）和日常生活活动能力量表（ADL）结果比较,差异无统计学意义（P〉0.05）。超早期治疗有利于患者的预后。结论 高血压性脑出血的治疗采用何种手术方式要根据患者的个体情况而定,影响预后的因素也较多,其中血肿量、手术时机、治疗方案的选择都是影响外科治疗高血压性脑出血的重要因素。

Objective To investigate the advantages and disadvantages and curative effect influencing factors of surgical treatment method of hypertensive cerebral hemorrhage. Methods A total of 60 patients with hypertensive cerebral hemorrhage in the department of surgery were randomly divided into craniotomy group（craniotomy evacuation of hematoma） and drainage group（drilling hematoma drainage）, and each group contained 30 cases. Surgical treatments were performed within 3~72 h after morbidity in the two groups. There were 25 cases undergoing ultra early treatment（6~7 h） and 35 cases undergoing surgical treatment after more than 7 h. Results The difference of Glasgow outcome scale（GOS） and activities of daily living（ADL） between the craniotomy group and drainage group had statistical significance（P〉0.05）. The ultra early treatment provided benefit for patients＇ prognosis. Conclusion The treatment method of hypertensive cerebral hemorrhage should be determined by patients＇ individual situation. There are various influencing factors for prognosis. Hematoma volume, operation opportunity, and choice of treatment schedule are all the important factors for the surgical treatment of hypertensive cerebral hemorrhage.