延髓腹外侧微血管减压术在高血压脑出血术中的应用  

Ventrolateral medulla oblongata neurovascular decompression for acute hypertensive intracerebral haemorrhage

作　　者：徐善水[1] 孙克华[2] 李振球[1] 孙康健[2] 华长春[2] 潘先文[1] 许安定[1] 李真保[1] 姚成军[1] 

机构地区：[1]皖南医学院弋矶山医院神经外科,芜湖241001 [2]南京军区总医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2003年第2期88-90,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：安徽省教育厅科研基金资助 (批准号 2 0 0 0 j12 3 9)

摘　　要：目的　探讨原发性高血压脑出血手术中 ,行延髓腹外侧微血管减压术对患者血压的影响。方法　对 15例高血压脑出血患者 (左侧基底节血肿 12例 ,右侧 3例 )在清除血肿后 ,即刻行后颅凹开颅延髓腹外侧微血管减压术(左侧 13例 ,右侧 2例 ) ,并监测术后血压和心电图改变。结果　左侧的 13例中 ,4例术后血压恢复正常 ,6例术后 1周内血压接近正常 ,2例改善不明显 ,1例无变化。 2例行右侧者术后血压无明显变化。结论　左侧延髓腹外侧血管减压术 ,可降低高血压脑出血患者的血压 ,避免高血压脑出血后再次出血 ,减少两次手术和麻醉的影响 。Objective To explore ventrolateral medulla oblongata neurovascular decompression in treatment of acute essential hypertensive intracerebral haemorrhage(HICH)and the effects on blood pressure.Methods Ventrolateral medulla oblongata neurovascular decompression was performed after removal of hematomas in 15 cases with acute essential hypertensive cerebral haemorrgage (of left basal ganglion hematomas in 13 cases right in 2 cases),and the blood pressure?EKG were monitored.Results Postoperatively,the blood pressure wes getting normal in 4 cases,approaching normality a week after operation in 6 cases while not changed obviously in 5 cases(of 2 cases with the right MVD).Conclusions Left ventrolateral medulla oblongata neurovascular decompression is benefit for decreasing blood pressure in patients with hypertensive intracerebral heamorrhage.This method might be avoiding reoperation,anesthesia and rebleeding postoperatively.It would be a new theory and effective method for refractory essential hypertension.

关 键 词：高血压脑出血 血肿清除 微血管减压术 延髓腹外侧区 

分 类 号：R743.34[医药卫生—神经病学与精神病学]