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目的:对应用小骨窗血肿清除术、大骨窗血肿清除术、穿刺血肿吸引术三种术式治疗高血压脑出血的临床疗效进行对比总结。方法:本组152例,其中小骨窗血肿清除术51例,随访40例;对照组101例,(其中大骨窗血肿清除术48例,随访35例;穿刺血肿吸引术53例,随访37例)。结果:小骨窗血肿清除术后死亡7例,死亡率13.7％;大骨窗血肿清除术后死亡9例,死亡率18.7％;穿刺血肿吸引术后死亡12例,死亡率22.6％。随访1年,ADL(日常生活能力)分级评价,功能恢复至Ⅰ、Ⅱ、Ⅲ级水平的总例数:小骨窗血肿清除术35例,占随访人数的87.5％;大骨窗血肿清除术28例,占随访人数的80％;穿刺血肿吸引术30例,占随访人数的81％。结论:小骨窗血肿清除术手术时间短,减压充分,止血彻底,并发症少,死亡率低,远期恢复效果好。
OBJECTIVE: To compare and summarize the clinical curative effect of three kinds of surgical treatment of hypertensive intracerebral hemorrhage by using small bone window hematoma removal, large bone window hematoma removal and puncture hematoma aspiration. Methods: The group of 152 cases, including small bone window hematoma in 51 cases, 40 cases were followed up; the control group of 101 cases (including large bone window hematoma in 48 cases, followed up 35 cases; puncture hematoma aspiration in 53 cases, followed up 37 cases ). Results: 7 cases died of small bone window hematoma, 13.7% died; 9 cases died of large bone window hematoma, the mortality rate was 18.7%; 12 cases died of puncture hematoma, the death rate was 22.6%. The follow-up of 1 year, ADL (daily living ability) grading evaluation, functional recovery to the level of Ⅰ, Ⅱ, Ⅲ level of the total number of cases: small bone window hematoma in 35 cases, accounting for 87.5% of the follow-up; large window hematoma 28 Cases, accounting for 80% of the follow-up; Thymoid aspiration surgery in 30 cases, accounting for 81% of the follow-up. Conclusion: The operation of small bone window hematoma is short, the decompression is sufficient, the hemostasis is complete, the complication is low, the mortality is low and the long-term recovery is good.