摘要
目的：对 365例高血压性脑出血的手术治疗进行总结，分析手术时机和手术方法对治疗效果的影响。方法：根据患者入院时的一般情况、意识状态、出血部位、血肿量的多少确定手术时机，采用锥颅和钻孔行血肿或脑室穿刺，血肿部分抽吸后置管外引流和／或灌注尿激酶溶解血肿治疗 79例，置管时间 4～ 12d，平均 8d； CT导向立体定向血肿排空术治疗 26例；小切口钻孔扩大骨窗 3～ 4cm直视下血肿清除术治疗 129例，开颅血肿清除术治疗 131例，其中去骨瓣外减压 44例。结果：治疗结果应用格拉斯哥治疗结果分级评价：良好 92例 (25. 2％ )，中残 107例 (29. 3％ )，重残 85例 (23. 9％ )，植物生存 2例 (0. 5％ )，死亡 79例 (21. 5％ )。结论：高血压性脑出血的外科手术治疗效果与手术时机的正确把握相关，恰当的手术方法不仅提高患者的生存率，而且能提高患者的生存质量，获得满意效果。
Objective:To analyze the effect of surgical times and surgical methods on surgical treatment of 365 cases of the patients with hypertensive intracerebral hemorrhage.Methods:The appropriate opportune moment and pattern of operation were determined according to the general condition,the state of consciousness,the position and capacity of hemorrhage.79 cases of the patients were treated using the puncture and aspiration of hematoma and ventriculocentesis,then drainage(to put the tube for 4～ 12 days,average was 8 days)or perfusion with abburokinase.26 cases of the patients were treated by the stereotactic hemorrhage aspiration guided under CT.129 cases of the patients were treated using the hematoma dissection with a small incision and extended bone window(3～ 4 cm).131 cases were performed the hematoma dissection with craniotomy.Results:According to Glasgou outcome scale:good 92 cases (25.5％ ),moderate mayhem 107 cases (29.3％ ),serous mayhem 85 cases (23.9％ ),vegetative life 2 cases (0.5％ ),death 79 cases (21.5％ ).Conclusions:The effects of surgical treatment of the disease were determined by the appropriate opportune moment and pattern of operation.The appropriate opportune moment and pattern of operation.The appropriate opportune moment and pattern of operation not only raise the survival rate but also improve the survival quality.
出处
《大理医学院学报》
2001年第3期50-52,共3页
Journal of Dali Medical College
关键词
高血压脑出血
外科治疗
立体定向血肿排空术
Hypertensive intracerebral hemorrhage
Surgical treatment
Stereotactic hemorrhage aspiration.
