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目的总结老年自发性脑出血急性期临床处置经验,进一步提高老年患者自发性脑出血的临床疗效,降低死亡率、致残率。方法对171例60岁以上老年急性自发性脑出血患者临床资料进行分析,总结不同的处置方法对预后的影响。结果 60～70岁年龄组手术有效率为85%,保守治疗有效率81.3%;70岁以上组手术有效率为48.8%,保守治疗有效率66.0%。结论老年自发性脑出血患者急性期的处置是关键,提倡遵循个体化治疗原则。颅内压的控制效果是决定选择手术还是保守治疗方式的重要依据。最小的损伤、最快的速度清除血肿是老年自发性脑出血患者急性期手术治疗的原则。
Objective To summarize the experience of clinical treatment of acute cerebral hemorrhage in elderly patients with acute phase to further improve the clinical efficacy of spontaneous cerebral hemorrhage in elderly patients and reduce mortality and morbidity. Methods Clinical data of 171 patients with acute cerebral hemorrhage above 60 years of age were analyzed, and the effects of different treatment methods on prognosis were summarized. Results The operative efficiency was 85% in the 60-70 age group and 81.3% in the conservative treatment group. The operative efficiency was 48.8% in the group of over 70 years old and 66.0% in the conservative treatment group. Conclusion The treatment of acute cerebral hemorrhage in elderly patients during the acute phase is the key to follow the principle of individualized treatment. The control effect of intracranial pressure is to decide the choice of surgery or an important basis for conservative treatment. Minimal injury, the fastest rate of removal of hematoma is a principle of acute surgical treatment of elderly patients with cerebral hemorrhage.