早期小骨窗微创手术治疗高血压脑出血的研究  

Early minimally invasive surgical treatment for hypertensive intracerebral hemo rrhage

作　　者：苏宁[1] 张瑞剑[1] 云强[1] 赵卫平[1] 张仲[1] 

机构地区：[1]内蒙古自治区医院神经外科,内蒙古呼和浩特010017

出　　处：《中华急诊医学杂志》2005年第8期659-662,共4页Chinese Journal of Emergency Medicine

基　　金：国家"十五"科技攻关计划课题[2001BA703B16(13)]

摘　　要：目的探讨早期小骨窗微创手术治疗高血压脑出血的疗效.方法对73例高血压脑出血患者在局麻加基础麻醉下早期行小骨窗微创脑内血肿清除术,残余血凝块数日后穿刺进一步清除.结果本组73例患者按GOS(愈后)转归标准:恢复良好35例;中度病残24例;重度病残4例;植物生存0例;死亡10例.死亡患者均属GCS 3～5分者,病死率明显降低,无手术并发症.结论早期小骨窗微创血肿清除技术被广泛应用,较传统开颅手术人为脑组织损伤较少,有较好的疗效,有取代开颅手术的趋势.此手术方法与传统手术比较,能迅速缓解颅内压,早期减轻血肿造成的占位效应及脑缺血,且减少血肿在凝结及液化分解过程产生的继发性脑损伤,病程明显缩短,疗效满意,使治疗费用降低.Objective To study the effeet of early minimally invasive surgical treatment for hypertensive intracerebral hemorrhage. Methods Serenty-three patients received mininally mvasire surgical treatment under regional anesthesia plus basic anesthesia. The remaining blood clot woule be removed after a few days. Results According to Glasgow outcome scale, 35 of the 73 patients had good recovery, 24 had moderate deficits and 4 had severe deficits, only 10 died, and no patients had persistent vegetative status. And the dead bdlonged to GCS 3 - 5 patients. Mortality were reduced distinctly.No complication after operation appeared in the survival. Conclusion Early minimally invasive surgical is applied extensively had effect than traditional craniotomy. This operation could decrease intracranial pressure rapidly, reduce mass effect, and secondary brain injuries. Course of treatment is obviously shortered.

关 键 词：早期 小骨窗 微创手术 高血压 脑出血 脑组织 

分 类 号：R651.12[医药卫生—外科学]