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目的：评估老年人高血压脑出血的外科治疗效果，并寻找最佳治疗方案。方法：研究７０例老年人高血压脑出血的外科治疗，其中３５例行立体定向抽吸术，３５例行开颅术。另外７０例非手术保守治疗病人作为对照。所有结果经统计学分析。结果：立体定向组和开颅手术组的死亡率低于保守治疗组（Ｐ＜０．０５）。立体定向组和开颅手术组的ＡＤＬ相近，但高于保守治疗组（Ｐ＜０．０５）。结论：年龄不是决定是否手术的主要指标，手术应是老年人高血压脑出血的重要治疗手段之一。同时还对ＧＣＳ评分、手术时机、手术方法、出血量、血肿的部位与预后、术后再出血等进行了讨论。
Objective: To evaluate the surgical treatment of hypertensive intracerebral hemorrhage in the elderly and to find the best treatment plan. Methods: Surgical treatment of hypertensive intracerebral hemorrhage in 70 elderly patients was studied. Among them, 35 patients underwent stereotactic aspiration and 35 underwent craniotomy. Another 70 patients with non-surgical conservative treatment as a control. All results were statistically analyzed. Results: The mortality rate in stereotactic group and craniotomy group was lower than that in conservative group (P <0.05). Stereotactic group and craniotomy group ADL similar, but higher than the conservative treatment group (P <0.05). Conclusion: Age is not the main index to decide whether to operate or not. Surgery should be one of the important treatments for hypertensive intracerebral hemorrhage in the elderly. At the same time, we also discussed the GCS score, operation timing, operation method, bleeding volume, hematoma location and prognosis, postoperative bleeding.