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目的 :总结重型出血性脑卒中 (SHS)的外科治疗经验 ,寻找术后病人死亡原因。方法 :回顾性分析 1 988年 1 0月～ 2 0 0 0年 8月连续外科手术治疗的 1 1 4例SHS病历 ,并对数据进行统计学处理。结果 :痊愈 41例(36 .0 % ) ,轻残 1 8例 (1 5 .8% ) ,重残 9例 (7.9% ) ,植物生存 3例 (2 .6 % ) ,死亡 43例 (37.7% )。根据不同的病情选择不同的手术时机和手术方法十分重要 ;血肿部位、血肿量、中线结构移位程度、意识障碍程度、瞳孔和对光反应情况等与预后明显相关。术前血压与预后呈非相关 (P >0 .0 5)。MSOF为SHS术后死亡的主要原因。结论 :正确地选择手术时机、手术方法及有效地防止并发症是降低病人死亡率的关键
OBJECTIVE: To summarize the experience of surgical treatment of severe hemorrhagic stroke (SHS) and to search for the causes of postoperative death. Methods: A total of 114 cases of SHS cases treated by continuous surgery between January 2008 and August 2000 were retrospectively analyzed. The data were statistically analyzed. Results: 41 cases (36.0%) were cured, 18 cases (15.8%) were lightly disabled, 9 cases (7.9%) severely disabled, 3 cases (3.6%) were plant survival and 43 cases (37.7% %). It is very important to choose different operation timing and operation methods according to different conditions. The location of hematoma, the amount of hematoma, the shift of midline structure, the degree of disturbance of consciousness, the pupil and the light response are obviously related to the prognosis. Preoperative blood pressure was not correlated with prognosis (P> 0.05). MSOF is the main cause of death after SHS. Conclusion: The correct choice of timing of surgery, surgical methods and effective prevention of complications are the key to reducing patient mortality