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目的为探讨幕上中等量血肿的高血压性脑出血的治疗策略、疗效。方法回顾性分析86例幕上中等量血肿(20-30 ml)病人的临床资料,均为高血压性脑出血。其中行微创手术治疗46例(手术治疗组),行保守治疗40例(保守治疗组)。结果手术治疗组病人平均住院时间、住院费用均明显低于保守治疗组(P<0.05)。术后随访3-18个月,按GOS评分:手术治疗组恢复良好32例,轻度残疾14例;保守治疗组恢复良好16例,轻度残疾19例,重度残疾4例,死亡1例结论对幕上中等量血肿的高血压性脑出血行微创钻孔、软通道穿刺血肿引流+尿激酶溶解术能明显减少病人平均住院时间、住院费用,改善近期预后。
Objective To investigate the treatment strategy and curative effect of hypertensive intracerebral hemorrhage with a moderate amount of hematomas on the screen. Methods The clinical data of 86 patients with moderate supratentorial hematoma (20-30 ml) were retrospectively analyzed. Both of them were hypertensive intracerebral hemorrhage. Among them, 46 patients underwent minimally invasive surgery (surgery group) and 40 patients underwent conservative treatment (conservative treatment group). Results The average length of stay and cost of hospitalization in the surgical treatment group were significantly lower than those in the conservative treatment group (P <0.05). The patients were followed up for 3-18 months. According to the GOS score, the surgery group recovered well 32 cases and mild disability 14 cases. The conservative treatment group recovered well 16 cases, mild disability 19 cases, severe disability 4 cases and death 1 case On the screen moderate hematoma of hypertensive intracerebral hemorrhage with minimally invasive drilling, soft-channel puncture hematoma drainage + urokinase lymphadenectomy can significantly reduce the average length of hospital stay, hospitalization costs and improve the near future prognosis.