高血压脑出血早期手术治疗临床分析

Clinical analysis of early operation on hypertensive cerebral hemorrhage

目的 对高血压脑出血早期 (发病后 2 4h内手术 )手术治疗效果进行探讨。方法 发病后不超过 2 4h的高血压脑出血 34例 ,采取小骨窗开颅血肿清除术 ,与同期延期 (2 4h后 )手术 2 3例、非手术 38例进行死亡率和生存质量对比分析。结果 早期手术组死亡 6例 ,死亡率 17.6 % (6 34) ,延期手术组死亡 9例 ,死亡率 39.1% (9 2 3) ,非手术组死亡 2 2例 ,死亡率 5 7.9% (2 2 38)。早期手术组术后生存质量良好率 6 4 .7% (2 2 34) ,延期手术组 34.8% (8 2 3) ,非手术组 18.4 % (7 38)。结论 高血压脑出血采取早期手术 ,快速、简单的手术方式 ,能降低死亡率 ,改善生存质量。

Objective To explore the effects of early operaiton (within 24 hours after onset) on the patients with hypertensive cerebral hemorrhage.Methods 34 patients with hypertensive cerebral hemorrhage were given hematoma evacuation by craniotomy with a small bone flap within 24 hours of bleeding. 23 patients with hypertensive cerebral hemorrhage were performed same operations after 24 hours. 38 patients received conservative therapy. The mortality and quality of lives were compared and evaluated. Results 6 cases died in early operation group, the mortality was 17.6%(6/34); 9 cases died in delayed operation group, the mortality was 39.1%(9/23); 22 cases died in non operation group, the mortality was 57.9%(22/38). The ratios of well living quality were 64.7%(22/34). 34.8%(8/23), and 18.4%(7/38) respectively. Conclusion The early and simple operation on patients with hypertensive cerebral hemorrhage can decrease the mortality and improve the living quality.