74例老年自发性小脑出血患者的临床分析及治疗选择  

Clinical analysis of 74 elderly patients with spontaneous cerebellar hemorrhage and the selection of treatment

作　　者：高广兴[1] 朱成伟 杨伟[3] 滕良珠[3] 刘雪平[3] 吴洪喜[3] 

机构地区：[1]胜利石油管理局临盘医院,德州251507 [2]枣庄市峄城区医院 [3]山东省立医院

出　　处：《中华老年心脑血管病杂志》2008年第8期604-606,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年人自发性小脑出血的病因、临床表现、治疗方法和预后。方法对74例小脑出血患者的临床资料进行回顾性分析。结果本组患者以高血压动脉硬化为主要病因。临床表现多不具有明显的特征。保守治疗40例中,治愈17例,好转18例,死亡5例。后颅窝开颅小脑内血肿清除及去骨瓣减压术治疗24例中,治愈11例,好转8例,死亡5例。CT引导立体定向血肿穿刺引流术3例,好转2例,死亡1例。单纯脑室外引流术7例,治愈2例,好转3例,死亡2例。小脑出血血肿量<10 ml者,首选保守治疗,血肿量≥10 ml者后颅窝开颅小脑内血肿清除及去骨瓣减压术疗效满意。结论CT引导立体定向血肿穿刺引流术、单纯脑室外引流术治疗老年人或体质差患者可提高治愈率。Objective To study the cause,clinical manifestatious,treatment and prognosis of spontaneous cerebellar hemorrhage in the elderly. Methods The clinical manifestations,imaging features, diagnosis and treatment in 74 cases of cerebellar hemorrhage were analyzed retrospectively. Results Cerebellar hemorrhage mainly occurred in elderly people,and hypertension was the main cause of the disease. Forty patients were treated conservatively, of them, 17 were cured, 18 improved and 5 died. Twenty-four patients underwent surgery,of them, 11 were cured,8 improved and 5 died. Three were treated with stereotactic operation,of them, 2 improved and 1 died. Seven were treated with extraventricular drainage,of them,2 were cured,3 improved and 2 died. It was better to treat conservatively the hematoma with a volume less than 10 ml. Traditional cranioto- my could be the first choice for the hematoma with a volume larger than 10 ml. Conclusion Stereotactic operation and extraventricular drainage are effective for the patients with advanced age or poor constitution.

关 键 词：脑出血 颅内动脉硬化 减压术 外科 引流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]