目的:探讨早期小骨窗开颅治疗高血压脑出血的手术方法及疗效.方法:对高血压脑出血52例发病后6～12 h内进行手术,通过长约6 cm的头皮直切口,直径3～4 cm的小骨窗开颅,沿脑沟切开皮层进入血肿腔中清除大部分血肿,术后经过血肿腔引流管注入尿激酶清除残余的血肿.结果:52例患者中恢复良好30例,中残8例,重残4例,植物状态3例,病死5例,自动出院2例.结论:早期小骨窗开颅清除高血压脑出血具有手术时间短、创伤小、恢复快、治愈率高等优点,适合在基层医院开展应用.%Objective: To explore application and effectiveness of craniotomy with small bone flap for the early treatment of hypertensive intracerebral hemorrhage. Methods:Fifty-two patients with hypertensive intracerebral hemorrhage were underwent surgical treatment within 6 to 12 hours after bleeding. Small bone flap with diameters of 3 to 4 cm were made through 6cm vertical scalp incision, and then the hematomas in cavity were cleaned out through cortical ostomy along sulcus. After surgery, hematomas cavities were perfused with urokinase through drainage-tube to cleare up the residual hematoma. Results: Among the 52 patients, 30 patients were good-recovery,8 patients were moderate-deficit,4 patients were severe-deficit, 3 patients were persistent vegetative status,5 patients died, and 2 patients self-discharged. Conclusions: Craniotomy with small bone flap have merits of short operative time, slight trauma,rapid recovery and high cure rate,for the early treatnent of hypertensive intracerebral henorrhage, and is suitable to apply in primary hospital.
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