微创血肿清除术治疗高血压性脑出血的临床研究

Clincal study of mini-traumatic evacuation of hematomas in treatment of HIH.

目的 :探讨微创血肿清除术治疗高血压性脑出血的临床疗效、手术适应证和手术时机。方法 :对 10 8例高血压性脑出血患者根据血肿部位、出血量、是否破入脑室等 ,联用或单用微创血肿引流术、侧脑室持续外引流术和腰穿CSF置换术 ,并观察其疗效。结果 :存活 82例 ,死亡 2 6例 ,死亡率为2 4 1% ,对存活病例随访半年 ,ADL119例 ,ADL2 30例 ,ADL3 18例 ,ADL411例 ,ADL54例。结论 :微创血肿清除术治疗高血压性脑出血是安全、有效的 ,特别适用于Ⅱ、Ⅲ级患者 ,且以早期手术为宜。

Objective: To study the effect,indication and timing of mini-traumatic evacuation of intracerebral hematomas in treatment of hypertensive intracerebral hemorrhage(HIH). Methods: We performed an observational study to 108 patients of HIH.Among 108 patients of HIH,82 cases were treated with hematomas drainage,51 cases were treated with ventricular drainage,35 cases were treated with CSF replacement,according to difference of the location and volume of hematomas,and the grades of patients condition. Results: Survival rates were 75.9%,mortality rates were 24.1%.Among the survival patients(n=82) who were followed up for six months,there were 39 cases of ADL 1,22 cases of ADL 2,11 cases of ADL 3,10 cases of ADL 4-5. Conclusion: Mini-traumatic evacuation of intracerebral hematomas is safe and effective for patients with grade two or three of HIH.