Abstract: Objective To analyze the causes and related factors of complications after operation of hypertensive intracerebral hemorrhage. Methods This was a retrospective analysis of 242 patients with hypertensive intracerebral hemorrhage who received minimally invasive burr-holecraniostomy and closed-system drainage （BCD） from August 2015 to September 2018. The efficacy， accuracy of catheter placement and the causes of complications such as catheter-related bleeding and infection were analyzed. Results Of the 242 patients， 114 had complications （47.1%）. Among 16 patients with rebleeding and requiring intervention， 7 cases were treated with re-catheterization， 9 cases were treated with conservative medical treatment， and 3 cases died. The cause of rebleeding was associated with the use of aspirin and anticoagulants， but not with age， sex， emergency operation and Kakarla classification. There were 8 cases of catheter-drainage infection in this group， 6 of which caused focal intracerebral abscess， and the other 2 cases were scalp redness and abscess caused by pericatheter infection， which were cured after dressing change and anti-infection.Among all the patients， 28 were completely recovered， 175 were significantly improved and 16 were not improved. According to ADL classification， there were 147 cases Ⅰ~Ⅱ， 67 cases Ⅲ~Ⅳ， and 5 cases Ⅴ， and 11 cases died during admission and 12 cases died during follow-up to 6 months. Conclusion Patients with hypertensive intracerebral hemorrhage have a high incidence of complications after cranial trepanation and drainage. Rehaemorrhage and infection are important risk factors to be dealt with.

Key words: hypertensive intracerebral haemorrhage, complications, Burr-hole craniostomy and drainage

摘要： 目的 分析高血压脑出血术后并发症的原因和相关因素。方法 采用回顾性分析方法，纳入2015年8月至2018年9月期间所有高血压脑出血接受微创的颅骨钻孔导管引流（BCD）的患者共242例，分析疗效、导管放置的准确性以及导管相关出血和感染等并发症的发病和原因。结果 242例患者中，术后共114人次发生各类并发症（47.1%）。16例发生再出血并需要干预的患者中，经再次置管处理7例，9例采取内科保守治疗，3例死亡。再出血与使用阿司匹林及抗凝药物有关联，与手术时间有关；但与年龄、性别、急诊手术、Kakarla 分级无关。本组病例中共8发生导管引流管相关感染，其中6例引发颅内感染，2例导管周围感染导致头皮红肿和脓性分泌物，经抗感染、换药后痊愈。所有患者中，完全恢复28例，明显改善和改善患者175例，无改善者16例；按照ADL分级，Ⅰ~Ⅱ：147例，Ⅲ~Ⅳ：67例，Ⅴ：5例；入院期间死亡11例，随访到6月增加12例死亡。结论 高血压脑出血患者行颅骨钻孔引流术后并发症发生率高，再出血和感染是需要处理的重要危险因素。

关键词: 钻孔引流术, 并发症, 高血压脑出血