早期小骨窗显微手术治疗高血压脑出血  

Microsurgery through small skull window in the early treatment of hypertensive intracerebral hemorrhage

作　　者：鲍洪[1] 吴开华[1] 丁轩[1] 招建华[1] 兰蒙[1] 

机构地区：[1]暨南大学医学院第三附属医院

出　　处：《中华神经医学杂志》2005年第6期618-619,共2页Chinese Journal of Neuromedicine

摘　　要：目的探讨高血压脑出血早期显微手术治疗的疗效。方法52例高血压脑出血患者发病后8￣24h小骨窗显微镜下行血肿清除手术治疗。结果48例患者术后24h内复查头颅CT,血肿清除率达90%以上30例,70%以上18例;4例血肿复发,行二次手术。术后存活46例,死亡6例。获随访46例,生活质量按日常生活能力(ADL)评价:Ⅰ级14例(30.4%),Ⅱ级15例(32.6%),Ⅲ级9例(19.6%),Ⅳ级6例(13%),Ⅴ级2例(4.4%)。结论早期小骨窗显微手术治疗高血压脑出血是一种安全有效的方法,疗效明显。Objective To explore the effect of early microsurgery through small skull window on the treatment of hypertensive intracerebral hemorrhage (HICH). Methods In 52 patients with HICH,hematoma was removed through small skull window under microscope in 8~24 h after onset. Results CT scan performed on 48 cases 24 h after surgery showed that >90% removal was achieved in 30 cases,>70% in 18 cases,reoccurrence in 4 cases (7.7%) who accepted second operation. 46 cases survived and 6 cases died postoperatively. 46 cases have been followed up,whose activities of daily living (ADL) is recovered to grade Ⅰ in 14 cases (30.4%),grade Ⅱ in 15 cases (32.6%),grade Ⅲ in 9 cases (19.6%),grade Ⅳ in 6 cases (13%),and grade Ⅴ in 2 cases (4.4%). Conclusion Early microsurgery through small skull window is a safe and effective method for treating HICH.

关 键 词：高血压脑出血 显微手术治疗 小骨窗 早期 日常生活能力 脑出血患者 血肿清除率 头颅CT 血肿复发 二次手术 生活质量 显微镜 发病后 24h 疗效 术后 

分 类 号：R651.1[医药卫生—外科学]