老年高血压脑出血早期个体化手术230例疗效分析

Treatment for senior patients with hypertensive intracerebral hemorrhage: analysis of 230 cases

目的探讨老年高血压脑出血早期个体化手术方法,以总结提高老年高血压脑出血治疗效果的治疗方法。方法对我科近5年收治的年龄在60岁以上老年性高血压脑出血230例,针对个体差异,采用大骨瓣开颅手术和小骨窗显微手术,进行回顾性分析。结果本组病230例,两种手术方法比较血肿清除率、死亡率、术后并发症、术后2周及术后6个月随访均无差异,但是术中输血量小骨窗显微手术组显著少于大骨瓣开颅手术组,且小骨窗显微手术组平均手术时间显著缩短。结论选择性采用大骨瓣开颅血肿清除术或小骨窗显微血肿清除术,对老年性高血压出血患者,应该根据临床情况来决定,选择个性化手术方式,在适宜时机进行手术治疗,提高老年高血压脑出血的疗效。

Objective The early individualized surgery for hypertensive intracerebral hemorrhage people was discussed in order to improve the treatment for senior patients. Methods Retrospective analysis of 230 senior patients （aged over 60） with hypertensive intracerebral hemorrhage was made in recent five years, who underwent the large bone flap surgery or small bone window craniotomy. Results There was no significantly statistical difference between the two groups in hematoma evacuation rate, mortality, and post-operative complications at post-operative 2 w and 6 months＇follow-up. But the amount of intra-operative blood transfusion and time of surgery was much less in small bone window eraniotomy group. Conclusion Selection of surgery method for senior patients should be decided according to clinical indices of patients with hypertensive intracerebral hemorrhage. Individualized surgery method and optional time of surgery can improve the outcome of senior patients with hypertensive intracerebral hemorrhage.