Abstract: Objective To explore efficacy of stereotactic puncture drainage in treatment of severe hypertensive intracerebral hemorrhage. Methods We collected the patients with spontaneous cerebral hemorrhage in the neurological care unit of First People' s Hospital of Hefei from Jan.2014 to Feb.2024.A total of 81 patients with severe hypertensive intracerebral hemorrhage were treated with two different groups (45 cases in the craniotomy group and 36 cases in the stereotactic puncture drainage group).The postoperative complications and functional recovery were compared between the two groups. Results There was no difference in postoperative intracerebral hematoma (P=0.58),mortality (P=0.69) and postoperative intracranial infection (P=0.63) between the two groups.The postoperative stress ulcer bleeding (P=0.04),the postoperative pneumonia (P=0.04) and the distribution of the neurological impairment score (P=0.03) after 6 months of surgery in stereotactic puncture drainage group was better than that in the craniotomy group. Conclusion Stereotactic puncture and drainage is safe and effective in the treatment of severe hypertensive intracerebral hemorrhage with the advantages of less complications and has high clinical reference value.

Key words: Severe cerebral hemorrhage, Stereotactic puncture and drainage, Neurological impairment score

摘要： 目的 探讨立体定向穿刺引流术对于重症高血压脑出血的手术效果。方法 将自发性脑出血手术患者进行回顾性分析,纳入重症高血压脑出血手术患者总计81例,其中立体定向穿刺患者36例,开颅手术患者45例,比较两组患者术后相关并发症及神经功能缺损差异。结果 两组手术患者在术后颅内感染(P=0.63),再出血(P=0.58)及死亡率(P=0.69)等方面无显著差异,立体定向引流可以更好的控制术后肺部感染(P=0.04)及应激性溃疡的并发症(P=0.04),取得良好的手术预后(P=0.03)。结论 立体定向穿刺引流是治疗重症高血压脑出血的有效治疗手段。

关键词: 重症高血压脑出血, 立体定向穿刺, 神经功能缺损评分