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目的探讨微创钻颅脑内血肿穿刺抽吸引流术治疗急性高血压脑出血的疗效。方法290例急性高血压脑出血患者发病至治疗时间为7～24h,靶点设在血肿最大层面的外1/3与后1/3交叉处,进行微创钻颅脑内血肿穿刺抽吸引流术,术中及术后控制血压。内科保守治疗的265例高血压脑出血患者作为对照。分别于入院2周、4周时按统一标准进行神经功能缺损评分。结果治疗组290例,其中显效85例,有效110例,效果差45例,死亡50例;总有效率67.24%,死亡率17.24%。对照组265例,其中显效10例,有效10例,效果差70例,死亡175例;总有效率7.55%,死亡率66.04%。两组总有效率和死亡率相差显著(P<0.01)。结论微创钻颅穿刺引流术治疗急性高血压脑出血临床效果显著。
Objective To investigate the curative effect of minimally invasive craniotomy and intracerebral hematoma aspiration and drainage on acute hypertensive intracerebral hemorrhage. Methods 290 patients with acute hypertensive intracerebral hemorrhage from onset to treatment for 7 ~ 24h, the target located at the outermost 1/3 of the hematoma and the latter 1/3 of the cross, minimally invasive drilling brain hematoma aspiration drainage Intraoperative and postoperative control of blood pressure. Conservative treatment of 265 patients with hypertensive intracerebral hemorrhage as a control. Neurological deficit scores were evaluated according to uniform standards at admission of 2 weeks and 4 weeks respectively. Results The treatment group of 290 cases, of which 85 cases markedly effective in 110 cases, 45 cases of poor results, 50 cases of death; the total effective rate was 67.24%, the mortality rate was 17.24%. The control group of 265 cases, of which 10 cases markedly effective in 10 cases, the effect of poor in 70 cases, 175 cases of death; the total effective rate was 7.55%, the mortality rate was 66.04%. There was a significant difference between the two groups in total effective rate and mortality (P <0.01). Conclusion Minimally invasive drilling craniotomy drainage for the treatment of acute hypertensive intracerebral hemorrhage clinical effect is remarkable.