慢性扩张性脑内血肿的诊断与治疗  

Diagnosis and treatment of chronic expanding intracerebral hematoma

作　　者：曲春城[1] 于锐[1] 王志刚[1] 徐淑军[2] 徐广明[3] 刘玉光[2] 张庆林[1] 

机构地区：[1]山东大学第二医院神经外科,济南250033 [2]山东大学齐鲁医院神经外科 [3]山东大学附属省立医院神经外科

出　　处：《中华医学杂志》2008年第11期746-748,共3页National Medical Journal of China

基　　金：山东大学“985”工程二期神经外科建设项目（10000065950010）

摘　　要：目的探讨慢性扩张性脑内血肿（CEICH）的发病机制、诊断及治疗方法。方法回顾性分析22例CEICH患者的临床表现、影像学检查、手术治疗及病理学诊断等资料。22例患者中男15例，女7例，年龄6～51岁，平均29．3岁。22例患者均进行了开颅手术清除血肿并切除血肿包膜治疗。术后随访1～20年。结果CEICH患者的临床表现及影像学表现均不典型。22例中18例恢复良好，3例偏瘫，1例因再次出血死亡。术中诊断及术后病理学诊断均为CEICH。结论病情呈慢性进行性加重、影像学显示脑实质内血肿样表现是CEICH的诊断要点。治疗应行开颅手术清除血肿并切除包膜。Objective To explore the diagnosis, therapeutic strategy, and pathogenetic mechanism of chronic expanding intracerebral hematoma （ CEICH ）. Methods The clinical presentation, radiological characteristics, d pathology, and treatment of 22 cases of CEICH, 15 males and 7 females, aged 29. 3, all treated with craniotomy and removal of the wall of the capsule and hematoma, were analyzed retrospectively. Results The clinical presentation and radiological characteristics of CEICH were atypical. After surgery, 18 patients recovered quite well, 3 patients suffered from hemiplegia, and 1 patient died from rebleeding. The diagnosis of CEICH of all the cases was confirmed by intraoperative finding and pathological results. Conclusion CEICH can be found in any part of the brain that has 2 major characteristics： its clinical symptoms always develop slowly, and the typical radiological characteristic is intracerebral hematoma-form image. Surgery to evacuate the hematoma and remove the capsule is necessary and can be with good outcome.

关 键 词：血肿 中枢神经系统血管畸形 诊断 

分 类 号：R686[医药卫生—骨科学]