老年患者高血压脑出血不同治疗方法的疗效比较

Comparison on effects of different treatments of hypertensive cerebral hemorrhage in elderly patients

目的:探讨老年高血压脑出血的救治方法。方法:回顾性分析本院2011年3月至2016年3月收治149例老年高血压脑出血病例,根据采用不同的治疗方式分成立体定向置管血肿外引流术组(置管外引流组)、大骨瓣开颅术组(开颅手术组)及内科保守治疗组(保守治疗组),并对其疗效进行比较。结果:置管外引流组预后良好率79.4%(50/63),开颅手术组预后良好率53.7%(22/41),保守治疗组53.3%(24/45)。置管外引流组预后良好率高于开颅手术组和保守治疗组预后良好率(χ2=11.466,P=0.001;χ2=12.163,P=0.000)。开颅手术组的预后良好率与保守治疗组之间差异无统计学意义(χ2=0.001,P=0.976)。结论:立体定向置管血肿外引流术能改善老年高血压脑出血患者预后,较大骨瓣开颅术及单纯内科保守治疗有一定优势。

Objective：To investigate the treatments of hypertensive intracerebral hemorrhage in elderly patients. Methods：A total of 149 elderly patients with hypertensive intracerebral hemorrhage were retrospectively analyzed from March 2011 to March 2016 of our hospital. According to the different treatment methods, the patients were divided into the stereotactic catheterization-hematoma external drainage group （ external drainage group） , large bone flap craniotomy group （ craniotomy group ） , and conservative medical treatment group （conservative treatment group）,and the effects between them were compared. The good prognosis rate in the external drainage group,craniotomy group and conservative treatment group was 79.4% （50/63）,53.7%（22/41） and 53.3% （24/45）,respectively. The good prognosis rate in the external drainage group was higher than that in the craniotomy group and conservative treatment group （ χ2=11. 466,P=0. 001;χ2=12.163,P=0.000） . There was no statistically significant difference in the good prognosis rate between the craniotomy group and conservative treatment group （ χ2=0.001,P=0.976）. Conclusion：Stereotactic catheterization-hematoma external drainage can improve the prognosis of elderly patients with hypertensive intracerebral hemorrhage. Large bone flap craniotomy and simple conservative treatment show certain advantages.