自发性脑出血不同外科治疗方法选择  

Different surgical treatment for spontaneous cerebral hemorrhage

作　　者：秦怀海[1] 任印斌[2] 刘智[1] 张楠[1] 许希海[2] 靳文毅[1] 程雷鸣 王文蕾 沈寻[1] 

机构地区：[1]北京煤炭总医院神经外科,100028 [2]安徽省淮北矿工总医院

出　　处：《中国综合临床》2008年第3期256-257,共2页Clinical Medicine of China

摘　　要：目的探讨自发性脑出血应用不同手术方法的治疗效果。方法自发性脑出血患者380例。行大骨瓣开颅56例，小骨瓣开颅38例，立体定向抽吸43例，锥颅碎吸55例，显微镜下小骨窗开颅188例。结果大骨瓣开颅血肿清除组治愈率44％，中重残率28％，病死率28％；单纯小骨窗开颅血肿清除组治愈率58％，中重残率24％，病死率18％；立体定向穿刺抽吸组治愈率60％，中重残率20％，病死率20％；锥颅碎吸组治愈率52％，中重残率25％，病死率23％；显微镜下小骨窗开颅血肿清除组治愈率85％，中重残率13％，病死率2％。总体治愈率为68％，中重残率19％，病死率13％。结论根据自发性脑出血患者的自身情况、科室的手术设备、医师技术水平、选择适当手术方法，可明显提高治疗效果。Objective To analyze the results of different surgical treatment for patients with spontaneous cerebral hemorrhage. Methods Opening skull with large bone petal was conducted in 56 cases, opening skull with small bone petal in 38 cases,stereotaxic pump in 43 cases,perforate evacuation in 55 cases, and opening skull with small bone petal under microscope in 188 cases. Results The cure rates were ,14% ,moderate and serious disability rates were 28% ,death rates were 28% in group of opening skull with large bone petal;The cure rates were 58%, moderate and serious disability rates were 24% ,death rates were 18% in group of opening skull with small bone petal; The cure rates were 60% ,moderate and serious disability rates were 20% ,death rates were 20% in group of stereotaxic pump; The cure rates were 52% ,moderate and serious disability rates were 25% ,death rates were 23% in group of perforate evacuation; The cure rates were 85% ,moderate and serious disability rates were 13% ,death rates were 2% in group of under microscope opening skull with small bone petal; The total cure rates were 68% ,moderate and serious disability rates were 19%, death rates were 13%. Conclusion Pertinent surgical treatment method is chosen according to patient＇s condition, operation equipment of section office and technique of physician ,so the curative effect would be increased obviously.

关 键 词：自发性脑出血 大骨瓣开颅血肿清除术 立体定向穿刺抽吸术 锥颅碎吸术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]