幕上高血压脑出血178例手术方式选择分析  

Analysis of operation mode for 178 cases of hypertension patients complicated with cerebral hemorrhage

作　　者：李凯[1] 乔冠群[1] 肖安平[1] 

机构地区：[1]南京医科大学第二附属医院,江苏南京210011

出　　处：《基层医学论坛》2011年第25期792-794,共3页The Medical Forum

摘　　要：目的探讨手术治疗高血压脑出血的术式选择。方法回顾性分析采用去骨瓣减压开颅血肿清除术、脑室引流术、脑内血肿立体定向抽吸术及脑室镜辅助下血肿清除术治疗178例高血压脑出血患者的临床资料。结果术后1个月存活144例,死亡34例。随访6个月预后良好77例,预后不良65例,死亡2例。结论高血压脑出血外科治疗主要目的是减压,不必强行清除全部血肿,宜最大程度保护神经功能及防止再出血。血肿周围脑叶与硬脑膜出现间隙是减压目的达到的标志。结合临床选择适当的手术方式是手术成功的关键。Objective To study the choice of operation model for hypertensive hemorrhage patients suffering from the intracranial hematoma clearance.Methods Clinical data of 178 patients performed by bone-out flat decompression hematoma clearance,ventficular drainage,intracerebral hematoma stereotaxis drainage and the endoscopic surgery were analyzed retrospectively.Results Among 178 cases,144 were survival and 34 died in 1 month after surgery.The following up of 6 months showed that,77 patients had good recovery,65 patients had severe disability and 2 patients died.Conclusion Intracerebral pressure should be reduced as soon as possible.The gap between lobe of brain around hematoma and cerebral dura mater is the sign.Choosing the best operation mode was key to gaining good effects of surgery.

关 键 词：高血压脑出血 手术方式 减压 预后 

分 类 号：R651.1[医药卫生—外科学]