【摘要】 目的　规范高血压脑出血 (ICH)手术适应证。方法　 1998年 1月 - 2 0 0 0年 12月 ,本课题组组织上海市 17家 2级和 3级医院开展ICH内外科规范化治疗的多中心临床试验 ,遵循大样本、前瞻性、随机对照的原则 ,应用累积logistic模型进行多因素逐步回归分析 ,确定预后独立相关因素 ,并就主要相关因素分层比较内、外科组疗效。结果　“临床分级”、“血肿量”、“意识状态”和“GCS评分”等指标是影响ICH预后的独立因素。临床分级为“重型”和“中型”以及血肿量 >30mL的ICH ,手术治疗效果优于内科保守治疗。临床分级为“轻型”和幕上血肿量 2 0～ 30mL的ICH内外科组疗效无差别。幕上ICH不同部位手术疗效无差别。结论　GCS为 7～ 12分的中、重型ICH及血肿量 >30mL则应首选手术治疗。更多还原

【Abstract】 Purpose To specify the indications of surgical treatment of hypertensive intracerebral hemorrhage (ICH). Methods During the period from Jan.1998 to Sep.2000,there was a prospective randomi-zed controlled clinical trial undertaken in 17 hospitals in Shanghai.The independent correlation factors were specified according to the multivariate statistical analysis,and the outcomes of non-surgical and surgical groups were compared with each other in different strata. Results The prognosis of ICH was based on the patient′s clinical grading,volume of hematoma,consciousness,and the Glascock Coma Scale (GCS) scale.For the ICH patients of severe and moderate clinical grade,or with hematomas larger than 30 mL,the outcome of surgical group was definitely better than non-surgical group.However,for the ICH patients of mild clinical grading,or with hematomas smaller than 30 mL,there was no significantly difference in outcome bet-ween non-surgical and surgical groups.There was also no significant correlation between the outcome and the location of supratentorial hematoma. Conclusions The study suggested the indications of surgical treatment of hypertensive intracerebral hemorrhage.更多还原