目的 探讨颅内血肿微创清除术对高血压性脑出血的临床疗效、手术时机选择和基层医院开展的可行性.方法 开展的微创治疗脑出血24例为微创组,内科治疗的脑出血26例为对照组,分析两组疗效.结果 有效率微创组87.5%,对照组为50%(P<0.01).两组病死率分别为4.2%和19.2%(P<0.01).存活患者的生存质量对比,微创组也明显优于对照组.本组发病后选择手术时间平均为24.2小时.结论 颅内血肿微创清除术治疗脑出血其疗效明显,手术时机选择1～3天为宜,适合基层医院开展.%Objective To discuss the clinical effect of microinvasive evacuation of hematoma in treatment of hypertensive intracere-bral hemorrhage, also the best time of the operation and the feasibility of being carried out in substrate hospital were studied. Methods 24 patients were treated with microinvasive evacuation. The therapy effect was compared with the effects of conservative internal medicine for control group (26 patients). Results The effective rate and fatality rate of this therapy which were 87.5% and 4. 2% respectively, were significantly different from the control group(P<0.01), which were 50% and 19.2% respectively. After operation, the patients'quality of life was obviously improved compared with that in control group. We found the best opportunity of the operation was about 24.2 hours after brain hemorrhage. Conclusion The therapeutic effect of microinvasive evacuation of hematoma in treatment of hypertensive intracercbral hemorrhage was significantly better than that of conservative internal medicine. As this therapy was easy to practice and then could be carried out in substrate hospital. The operation could be put into practice in 1 -3 days after intracerebral hemorrhage.
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