【摘要】 目的探讨不同手术方法对高血压脑出血患者的治疗效果。方法采用前瞻性随机对照方法将263例高血压脑出血患者分为两组,即直视下开颅血肿清除组(n=78)和钻孔血肿引流组(n=185),出院后3～6个月按ADL评定两组患者的远期疗效。结果术后开颅组死亡16例(20．5%),引流组死亡34例(18．4%),两组患者的病死率间差别无显著性意义(P＞0．05);出院3～6个月后,开颅组预后不良(ADL 4～6分)41例(52．6%),引流组预后不良90例(48．6%),两组间差别无显著性意义(P＞0．05);对体积＞50 ml的血肿患者,开颅组预后不良28例(35．9%),引流组预后不良57例(30．8%),两组间差别有显著性意义(P＜0．05)。结论出血量＞50 ml的患者行开颅血肿清除术预后较好,对高血压脑出血患者的治疗不应强调某一术式明显优越,根据血肿量和病情分级选择治疗方法是手术成功的关键。更多还原

【Abstract】 Objective To study the therapeutic efficacy of hypertensive intracerebral hemorrhage (HICH) by two op- erative methods.Methods Using perspective randomized controlled method,78 cases of 263 HICH cases were operated craniot- omy,and the rest 185 cases were carried out by puncture drainage.The forward curative effect was evaluated and investigated by activities of daily living (ADL) on the two groups in 3～6 months after leaving the hospital.Results Sixteen patients (20.5%) died after operation in craniotomy group while 34 patients (18.4%) died in drainage group.There was no significant- ly difference between the two groups (P＞0.05).Forty- one patients with eraniotomy and 90 patients) with puncture drainage had unfavorable prognosis (ADL 4～6 grade ) and no significant difference was found between the two groups.But it appeared significant differenee between the two groups in which patients had more than 50ml blood (P = 0.034),28 cases in eraniotomy group and 57 cases in puncture drainage with unfavorable prognosis respectively.Conclusion Which operative methods to choose depends on the blood quantity and the pathogenetic conditions in HICH.更多还原