显微手术及微创术治疗高血压脑出血对照探究.doc

显微手术及微创术治疗高血压脑出血对照探究[摘要] 目的 探讨显微手术和微创术治疗高血压脑出血的方法和临床疗效。方法 选择2005年6月～2010年6月在我院治疗的335例高血压脑出血患者，其中182例进行小骨窗下显微手术治疗，153例进行微创钻孔引流术治疗，对两组进行对照研究并观察疗效。结果 显微手术组治疗182例，结果抢救存活123例，总有效率占67.58%，死亡59例，占32.42%；微创手术组治疗153例，结果抢救存活126例，总有效率占82.36%，死亡27例，占17.64%。结论 显微镜下手术与微创手术比较，周围正常脑组织损伤较大，手术后并发症多，死残率高。采用微创手术治疗高血压脑出血比较方便、疗效好，显著提高了生存率和生存质量。 [关键词] 显微手术；微创术；高血压脑出血 [中图分类号] R651.1 [文献标识码] B [文章编号] 1673-9701（2011）24-65-03 Comparative Study of Microsurgery and Wicresoft Operation Treating Hypertensive Intracerebral Hemorrhage RUI Yifeng XU Deming TANG Yuming Department of Neurosurgery，the First Hospital of Jiaxing City in Zhejiang Province，Jiaxing 314001，China [Abstract] Objective To explore the methods and clinical effect of microsurgery and wicresoft operation treating hypertensive intracerebral hemorrhage. Methods All 335 patients with hypertensive intracerebral hemorrhage were divided into microscopic therapy group and wicresoft therapy group. The effects were in two groups were observed. Results There were 182 cases in the Microsurgery therapy group，to save life 123 cases（67.58%）；death 59 cases（32.42%）. There were 153 cases in the Wicresoft therapy group，to save life 126 cases（82.36%），death 27 cases（17.64%）. Conclusion Compared with Wicresoft operation，surrounding normal brain tissue damage larger，have more complications after the operation and the death rate is higher treated with Microsurgery. Wicresoft operation uses conveniently，hypertensive intracerebral hemorrhage，and marked curative effect of the wintering sites and the existence of quality. [Key words] Microsurgery；Wicresoft operation；Hypertensive intracerebral hemorrhage 高血压脑出血一直以来严重危害人类的生命健康，在我国居民中发病率较高，约占全部脑卒中的30%～38%，明显高于欧美国家的发病率10%左右[1]，治疗方法可分为内科保守治疗和外科手术治疗，手术治疗在高血压脑出血的治疗中发挥越来越重要的作用[2]，目前临床最常用的为小骨窗开颅血肿清除术、钻孔穿刺血肿碎吸引流术，对这两种手术方式的利弊报道较多，我院对上述两种手术方式进一步精细化并进行对照研究，在2005年6月～2010年6月5年期间对收治的335例高血压脑出血患者采用小骨窗下显微手术治疗（显微手术组）和微创钻孔引流术（微创手术组）治疗，现将报道如下。 1 资料与方法 1.1 一般资料 1.1.1 病例纳入标准 ①经颅脑CT确诊的自发性基底节脑出血；②出血量