手术治疗重型基底节区高血压脑出血疗效观察  

Observation of the curative effect of surgical treatment on severe hypertensive intracerebral hemorrhage in basal ganglia region

作　　者：张山[1] 要跟东[1] 任洪波[1] 祁红辉[2] 牛国栋[1] 刘斌[1] 董雨[1] 胡志恒[1] 

机构地区：[1]河北省邯郸市中心医院,河北邯郸056001 [2]河北省邯郸市第一医院,河北邯郸056002

出　　处：《现代中西医结合杂志》2014年第4期363-365,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的对比分析3种术式治疗重型基底节区高血压脑出血（HICH）的疗效，探讨手术治疗策略。方法270例重型基底节区HICH患者分为大骨瓣开颅血肿清除术组120例、小骨窗开颅血肿清除术组90例和血肿穿刺引流辅助开颅血肿清除术组60例，观察术后1个月病死率及术后6个月日常生活能力良好率。结果3组术后1个月病死率无显著性差异，血肿穿刺引流辅助开颅血肿清除术组术后6个月日常生活能力良好率优于另2组（P均〈0．05）。结论重型基底节区HICH，推荐在发病后6～24h内手术治疗，可首选血肿穿刺引流辅助开颅血肿清除术。Objective It is to evaluate and compare the therapeutic effects of three kinds of surgeries on severe hypertensive intracerebral hemorrhage（HICH） in basal ganglia region,and to explore the optimal surgical therapy suitable for this disease. Methods 270 patients with HICH in basal ganglia region were divided into 120 cases operated by the big bone disc cranioto- my, 90 cases operated by the small bone window surgery and 60 cases operated by the big bone disc craniotomy after simply directional craniopuncture. Postoperative mortality in 1 st month and activity of daily living in sixth month by ADL scale were respectively analyzed. Results There was no significant difference in postoperative mortality in 1st month among the three groups. The postoperative activity of daily living in sixth month of the group treated by the big bone disc craniotomy after simply directional craniopuncture was better than that of the other groups（ P 〈 0.05 ）. Conclusion Patients with severely hypertensive intraeerebral hemorrhage in basal ganglia region should be operated in 6 - 24 hours after the onset of the disease. The big bone disc craniotomy after simply directional craniopuncture could be the first-line therapy.

关 键 词：脑出血 高血压 手术 基底节区 

分 类 号：R743.34[医药卫生—神经病学与精神病学]