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随着神经外科技术的发展和CT的普及应用,对高血压性脑出血能够早期做出诊断,通过急症手术,使多数危重病人得到及时救治和康复。本文总结我院78例高血压基底节出血超早期手术治疗,观察其近期疗效,并对影响因素进行探讨。 资料和方法 我科自1986年3月到1993年12月,对经CT确诊的78例高血压性基底节出血病人实行了超早期手术治疗。男46例,女32例,年龄38～76岁,平均57.3岁。全部病例均有高血压史,平均收缩压≥22.3kPa,舒张压≥12.6kPa。分析影响近期疗效的因素包括:1.手术前意识状态(GCS)计分;2.中线结构移位程度;3.血肿分型;4.手术方式。根据血肿量和陆氏提出的CT分型方法,本组基底节出血分为3个类型,1.局限型:血肿≤30ml,血肿2个长轴≤3.5cm。2.轻度扩展型:血肿≤50ml,2个长轴≤4.5cm.3.重度扩展
With the development of neurosurgery technology and the popularization and application of CT, early diagnosis of hypertensive intracerebral hemorrhage can be made. Through emergency surgery, most critically ill patients are treated and recovered promptly. This article summarizes 78 cases of hypertensive basal ganglia hemorrhage in our hospital ultra-early surgical treatment, to observe the short-term efficacy, and to explore the influencing factors. Materials and Methods Our department from March 1986 to December 1993, the CT confirmed 78 cases of hypertensive basal ganglia hemorrhage patients with ultra-early surgical treatment. 46 males and 32 females, aged 38 to 76 years, mean 57.3 years. All cases have a history of hypertension, the average systolic blood pressure 22.3kPa, diastolic blood pressure 12.6kPa. Analysis of the factors that affect the short-term efficacy include: 1. Preoperative consciousness status (GCS) score; 2. Midline structure shift; 3. Hematoma classification; 4. Surgery. According to hematoma volume and Lu’s CT classification method, the group of basal ganglia hemorrhage is divided into three types, 1. Limit type: hematoma ≤ 30ml, hematoma 2 long axis ≤ 3.5cm. 2. Mild expansion type: hematoma ≤ 50ml, 2 long axis ≤ 4.5cm.3. Severe expansion