微创手术治疗幕上高血压脑出血

目的观察微创手术治疗幕上高血压脑出血的疗效。方法选择本院幕上高血压脑出血患者45例,27例采用穿刺引流术治疗,18例采用骨窗血肿抽吸术治疗,治疗6个月后采用日常生活活动能力（ADL）量表评价治疗效果。结果治疗后ADL评级Ⅰ级12例,Ⅱ级14例,Ⅲ级9例,Ⅳ级4例,Ⅴ级2例。2例发生再出血形成脑疝,其中1例重新行常规骨瓣开颅手术,6个月时ADL评级恢复为Ⅳ级,另1例家属拒绝开颅手术,患者自动出院后死亡。2例术后并发肺部感染死亡。结论微创手术是治疗幕上高血压脑出血的一种有效方法,并且根据病情个体化选择合理的微创技术能明显提高疗效,改善患者生存质量。

The effect of minimally invasive surgery treatment of hypertensive intracerebral hemorrhage

Objective To observe the effect of minimally invasive surgery in treatment of hypertensiveintracerebral hemorrhage（HICH）. Methods 45 cases of patients with HICH in our hospital were selected, 27 cases were given brain ventricle puncture and drainage treatment, and 18 cases were given small window hematoma stereotactic aspiration. 6 months after treatment, ADL was used to evaluate the effects of treatment. Results ADL level was classⅠin 12 cases, class Ⅱ in 14 cases, class Ⅲ in 9 cases, class Ⅳ in 4 cases, class Ⅴ in 2 cases. 2 cases had cerebral rehaemorrhagia and caused cerebral hernia, of which one case was given conventional bone flap craniotomy surgery, and ADL level was class Ⅳ 6 months after treatment, the other one patient died after discharged from hospital because rejection of the regular operation. 2 cases died after the minimally invasive surgery because of lung infection. Conclusion Minimally invasive surgery is an effective method to treat hypertensive intracerebral hemorrhage, and individual choice of reasonable minimally invasive technology can obviously improve curative effect, improve quality of life.