摘要
目的探讨超早期显微外科手术治疗高血压小脑出血临床效果。方法回顾性分析65例高血压小脑出血患者超早期显微外科手术治疗的临床资料,应用GOS评分指标评判预后,进行回顾性分析研究。结果术后1d复查头颅CT,血肿完全清除49例,血肿大部分清除(血肿残留<30%)16例,20例行侧脑室外引流术。存活61例,死亡2例,放弃治疗2例。术后随访3个月,根据日常生活能力(activities of daily living,ADL)分级:优,ADL 1～2级(家庭生活独立)42例(68.85%),良,ADL 3级(生活部分自理)11例(18.03%),中,ADL 4级(清醒卧床)7例(11.48%);差,植物状态生存1例(1.64%),优良率86.88%,病死率3.08%。结论超早期显微外科手术治疗高血压小脑出血手术创伤小,手术时间短,止血确切,血肿清除理想,是一种简便、安全、有效的治疗方法,值得基层医院推广。
Objective To explore the clinical efficacy of ultra early microsurgery on patient with hypertensive cerebellar hemorrhage.Methods We reviewed the clinical data of 65 patients who suffered hypertensive cerebellar hemorrhage and accepted the ultra-early microsurgeries.The prognoses were evaluated by GOS(Glasgow Outcome Scale)score index.Results CT reexaminations after 1 day of operations showed that the hematoma was completely removed in 49 patients,most of the hematoma(>70%)was removed in 16 patients,lateral ventricle drainage was used in 20 patients.There were 61 cases of survival,2 cases of death and 2 cases of abandoning therapy.Patients were followed up for 3 months and were graded by activities of daily living(ADL),including 42 cases(68.85%)on ADL 1-2 grade,11 cases(18.03%)on ADL 3 grade,7 cases(11.48%)on ADL 4 grade,1 case(1.64%)on persistent vegetative state.Excellent rate was 86.88%,death rate was 3.08%.Conclusion With the advantages of small surgical trauma,short procedure time,exact hemostasis and few hematoma,ultra microsurgery has been proved to be a simple,safe and effective method to treat hypertensive cerebellar hemorrhage,and deserves to be popularized in basic level hospitals.
作者
袁军辉
石东付
吕岩松
董超峰
张少伟
YUAN Junhui;SHI Dongfu;LYU Yansong;DONG Chaofeng;ZHANG Shaowei(Department of Neurosurgery,Central Hospital of Sanmenxia,Sanmenxia 472000,China)
出处
《中国实用神经疾病杂志》
2018年第21期2404-2408,共5页
Chinese Journal of Practical Nervous Diseases
关键词
超早期
显微外科手术
高血压
小脑出血
预后
Ultra early
Microsurgery
Hypertensive
Cerebellar hemorrhage
Prognosis
