高血压脑出血微创手术与非手术治疗临床分析.docVIP

高血压脑出血微创手术与非手术治疗临床分析 　　[摘要] 目的:对高血压脑出血微创手术与非手术患者的治疗效果进行比较。方法:对35例病例进行随机分组,其中微创手术组(手术组)16例,非手术组19例,均为高血压患者。有意识障碍20例,手术12例,非手术8例。出血部位及出血量:手术组基底节出血5例,非手术组9例;脑室积血手术6例,非手术7例;出血量手术组100 ml,最少15 ml,非手术80 ml。手术时间:超早期10例,早期6例。手术方法:手术以钻孔及骨窗开颅为主,非手术组按内科常规治疗。结果:手术组死亡3例,均为基底节破入脑室;植物状态2例,不能自理生活1例,死亡致残率为37.5%;非手术组死亡4例,植物生存3例,不能自理生活4例,死亡率为57.9%。微创手术治疗效果与内科治疗效果有明显差异。结论:对于高血压脑出血患者的治疗,采用微创手术即操作简单、安全且便宜,对血肿量、部位、年龄的选择性不大。 　　[关键词] 高血压;脑出血;微创手术;非手术 　　[中图分类号] R743.34 [文献标识码]B[文章编号]1673-7210(2010)06(a)-231-02 　　 　　Clinical analysis of minimally invasive surgery and non-surgical treatment in hypertensive cerebral hemorrhage 　　GU Xiaohui, ZHANG Yucheng, WU Shengqing, YE JianTang, WU Haiqing, LI Jingdong 　　(Department of Neurosurgery, Shijie People′s Hospital of Dongguan City, Dongguan 523290, China) 　　[Abstract] Objective: To analyze effect of the minimally invasive surgery and non-surgery treatment on the patients with hypertension cerebral hemorrhage. Methods: 35 cases randomized, 16 cases of minimally invasive surgery, 19 cases of non-surgery, all patients with hypertension. 20 cases of conscious obstacles, 12 cases of surgery, 8 cases of non-surgery. Location and amount of bleeding: 5 cases of basal ganglia hemorrhage in operation group, 9 cases in the non-surgery group; 6 cases of Intraventricular hemorrhage in operation group, 7 cases in the non-surgery group; bleeding volume in operation group is 100 ml, at least 15 ml, non-surgery 80 ml. Operation time: super-early 10 cases, early 6 cases. Surgical methods: drilling and bone window craniotomy mainly in operation group, conventional medical treatment in the non-surgery group. Results: 3 cases deaths in operation group, which were basal ganglia hemorrhage rupturing into ventricle; 2 cases in a persistent vegetative state, 1 case in disability living, mortality and disability rate was 37.5%. 4 cases deaths in non-surgery group, 3 cases in persistent vegetative state, 4 cases in disability living, mortality rate was 57.9%. Results