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高血压脑出血是神经内科急危重症 ,死亡率及致残率高 ,我们从 1997年至今采用YL -1型颅内血肿粉碎穿刺针 ,治疗高血压脑出血 2 0 0例。结果 :血肿清除情况 ,首次清除率 :2 9 5 82 5 % ,平均为 3 1 7% ,总清除率 60 2 % 91 3 % ,平均约为 84 1% ,死亡率 :治疗组为 17% ,明显低于对照组 5 4% ,再出血发生率 ,治疗组为 8% ,对照组为 7 1% ,两组相比无明显差异 ,神经功能恢复情况 :治疗组 166例中ADLⅠ -Ⅲ级为 10 6例 ,对照组 3 2例 ,仅有 5例 ,两组相比有显著差异 (P <0 0 1)。讨论 :高血压性脑出血引起的神经损伤常由于血肿的占位效应 ,造成脑组织直接受损以及血肿周围脑组织水肿引起的继发性脑损伤。我们治疗病例大部分在 6小时 3天内 ,而再出血机率为 8% ,与内科保守治疗7 1%无明显差异 ,因此我们倾向早期穿刺手术 ,较安全疗效好 ,总之 ,微创手术操作简单 ,易于掌握 ,要求条件简单 ,适合高血压脑出血患者的治疗 ,且易在基层医院开展。
Hypertensive intracerebral hemorrhage is an acute and critical neurology department with a high mortality and morbidity. Since 1997, we have used YL-1 intracranial hematoma crush puncture needle to treat 200 cases of hypertensive intracerebral hemorrhage. Results: The initial clearance rate was 295 82.5% with an average of 31.7%. The total clearance rate was 60.2% 91.3% with an average of 84.1%. The mortality rate was 17% in the treatment group, Significantly lower than the control group 54%, the incidence of rebleeding, the treatment group was 8%, the control group was 71%, no significant difference between the two groups, the recovery of neurological function: 166 cases of treatment group ADL Ⅰ-Ⅲ grade was 10 6 cases, control group 32 cases, only 5 cases, there was significant difference between the two groups (P <0.01). Discussion: Hypertensive intracerebral hemorrhage caused by nerve injury often due to hematoma mass effect, resulting in direct damage to brain tissue and brain tissue around the hematoma caused by edema secondary brain injury. We treated most of the cases within 6 hours and 3 days, and the rate of rebleeding was 8%, conservative medical treatment with 71% no significant difference, so we tend to early puncture surgery, safer and more effective, in short, minimally invasive surgery is simple, Easy to grasp, the requirements are simple, suitable for the treatment of patients with hypertensive intracerebral hemorrhage, and easy to carry out in primary hospitals.