青年高血压基底节脑出血手术治疗术式分析

Surgery for basal ganglia cerebral hemorrhage of youth patients with hypertension

目的：探讨青年高血压基底节脑出血手术治疗术式。方法：回顾分析2012年1月～2015年4月分别采用了开颅去骨瓣减压血肿清除术和钻孔引流术两种术式治疗的46例青年高血压基底节脑出血患者的临床资料。结果：开颅手术28例患者,术后复查头颅CT,无再出血病例,残余血肿量2～6mL。钻孔引流术治疗18例患者,1例再出血给予开颅手术清除血肿,其余17例无再出血,术后3d17例患者血肿引流彻底。46例患者术后6个月复查,GOS评分轻残9例,中残33例,重残4例,疗效满意。结论：两种术式各有优缺点,青年高血压基底节脑出血患者需根据患者发病后病情进展速度、入院时患者意识状态及入院时头颅CT测得的血肿量,分别采用。

Objective：To discuss surgical treatment for basal ganglia cerebral hemorrhage of youth patients with hypertension.Methods：Clinical data of 46 young patients with hypertension and basal ganglia cerebral hemorrhage were retrospectively analyzed from January 2012 to April 2015,who received bone flap craniotomy decompression for removal of hematoma and drainage drilling..Results：There were 28 patients with craniotomy,and postoperative CT showed no further hemorrhage,and residual hematoma volume was 2-6mL.There were 18 patients with drilling drainage,including 1case with recurrence and craniotomy for treatment.Three days after treatment,17 cases showed thorough hematoma drainage.After 6months,out of 46 cases,there were 9cases with light disability via GOS scoring,33 cases with moderate disability,4cases with severely disability.The curative effect was satisfactory.Conclusions：Two kinds of operative methods each have advantages and disadvantages.The choice should be made according to disease progression,consciousness state on admission and hematoma volume measured by head CT,respectively.