高血压脑出血救治策略  

Hypertension Cerebral Hemorrhage Treatment Strategy

作　　者：赵宪林[1] 姜宏舟[1] 杜敬华[1] 刘国军[1] 关永昌[1] 

机构地区：[1]中国医科大学附属第四医院,辽宁沈阳110032

出　　处：《中国医药指南》2011年第12期26-28,共3页Guide of China Medicine

摘　　要：目的统计639例高血压脑出血救治病例,探讨高血压脑出血救治策略。方法救治手段,一是药物降低颅内压方法96例;二是外科手术干预543例。外科干预又分为开颅（66例）、穿刺（442例）、穿刺开颅结合（35例）,目的核心是降低颅内压力。统计患者发病1个月内死亡病死率、调查发病6个月存活患者的日常生活能力（ADL）、比较开颅与穿刺方法远期治疗效果。结果脑出血1个月内存活率为16.4%。存活患者的6个月ADL统计结果显示脑叶、脑室、小脑出血治疗效果优于基底节、脑干部位出血。ADLⅠ~Ⅲ级所占比例为93.4%。开颅与穿刺远期治疗效果比较没有明显区别（P〉0.005）。结论高血压脑出血救治不但要考虑个体适应证,还要考虑社会适应证和医院适应证。外科干预时机和处理方法要紧密结合实际。救治目标不仅考虑患者存活,更重要是存活质量。Objective Statistical treatment of hypertensive cerebral hemorrhage 639 cases and Investigate treatment strategies.MethodsDrug conservative 96 patients and surgical intervention in 543 cases.Surgical intervention is divided into craniotomy（66 cases）,puncture（442 cases）,puncture craniotomy combined（35 cases）.The core purpose is to reduce intracranial pressure.Statistics onset died within 1 month mortality,morbidity survey 6 months survival activity of daily living scale（ADL）,craniotomy and puncture compared long-term treatment effects.ResultsHemorrhage within 1 month survival rate was 16.4%.6 months survival in patients with ADL survey results show that brain lobe,ventricle hemorrhage,superior cerebellar hemorrhage in basal ganglia and brain stem.ADL Ⅰ-Ⅲ grade accounted for 93.4%.Craniotomy and puncture compared long-term treatment no significant difference（P0.005）.ConclusionsTreatment of hypertensive cerebral hemorrhage not only to consider the individual indications,but also to consider the indications of social and hospital.Surgical intervention timing and treatment method must be to realities.A treatment goal is not only to consider the survival of patients,but also survival of quality.

关 键 词：高血压脑出血 开颅 穿刺 

分 类 号：R743.34[医药卫生—神经病学与精神病学]