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目的 总结急诊锥颅血肿抽吸引流治疗高血压脑出血的临床疗效 ,进一步减少高血压脑出血早期病死率和致残率。方法 分析近 8年来我科急诊锥颅抽吸引流治疗高血压丘脑及基底节血肿共 32 4例的不同锥颅时间、血肿大小与预后的关系。结果 超早期手术 (发病后 3～ 7h) 14 2例 ,病死率 12 7% ;早期手术(发病后 7～ 4 8h) 114例 ,病死率 2 9 8% ;延期手术 (发病后 4 8～ 96h) 6 8例 ,病死率 6 1 8%。血肿 <30ml 5 6例 ,病死率 10 7% ;血肿 30～ 6 0ml2 10例 ,病死率 19 5 % ;血肿 6 1～ 90ml5 8例 ,病死率 81 0 %。结论 超早期急诊锥颅血肿引流是一种简便有效且安全的急救措施 ,特别适用于基层医院和垂危病人的急诊抢救。
Objective To summarize the clinical curative effect of aspiration and drainage of emergency cone cranial hematoma for hypertensive intracerebral hemorrhage and further reduce the early mortality and morbidity of hypertensive intracerebral hemorrhage. Methods In the past 8 years, we analyzed the relationship between different cranial skull time, hematoma size and prognosis in 324 cases of hypertensive thalamic and basal ganglia hematoma. Results 14 cases of ultra-early surgery (3 ~ 7h after onset), the mortality rate was 12.7%; 114 cases of early surgery (7 ~ 48h after onset), the mortality rate was 29.8%; postoperative delay (48 ~ 96h after onset ) 68 cases, fatality rate 61.8%. Hematoma <30ml 56 cases, the mortality rate 107%; hematoma 30 ~ 60ml2 10 cases, 19 5% mortality; hematoma 6 1 ~ 90ml5 8 cases, the mortality rate was 81%. Conclusion Super early emergency cone cranial hematoma drainage is a simple and effective and safe first aid measures, especially for emergency treatment of grass-root hospitals and critically ill patients.