重症高血压脑出血患者的超早期手术治疗  

Early surgical treatment of severe hypertensive cerebral hemorrhage

作　　者：许彦钢[1] 杨军[1] 秋南 张伟[1] 

机构地区：[1]陕西省人民医院神经外科,陕西西安710068

出　　处：《中国危重病急救医学》2000年第5期273-275,共3页Chinese Critical Care Medicine

基　　金：陕西省卫生厅科研基金资助项目!(97001)

摘　　要：目的 :探讨重症高血压脑出血的外科治疗方法。方法 :对 6 0例重症高血压脑出血患者进行超早期开颅血肿清除术 ,对瞳孔散大、脑疝形成患者行去骨瓣减压术 35例 (5 8.3% ) ,其余患者行颞肌下减压术。结果 :术后除 1例出血量大 ,术后 6小时死亡外 ,其余患者脑疝解除 ,当日清醒 18例 ,意识朦胧 6例 ,浅昏迷 30例 ,深昏迷 5例。手术后 1个月功能恢复至 ～ 级 10例 , ～ 级 33例 , 级 7例 ,死亡 10例 (16 .7% )。结论 :对于重症高血压脑出血患者行超早期手术治疗能够降低病死率 。Objective:To explore the surgical treatment for severe hypertensive cerebral hemorrhage.Methods:60 cases of severe hypertensive cerebral hemorrhage were treated with open evacuation of hypertensive intracerebral hemorrhage within 7 hours.Results:One case died of severe hemorrhage 6 hours after operation,and encephalocele of the others was relieved.There were 18,6,30 and 5 cases in consciousness,clouding of consciousness,mild coma and deep coma respectively at the operation day.The ability of life daily recovered to ⅠⅡ with 10 cases,ⅢⅣ with 33 cases,Ⅴ with 7 cases and 10 cases died.Conclusions:Evacuation of hypertensive intracerebral hemorrhage surgically is an effective treatment for severe hypertensive cerebral hemorrhage.It is of significance in diminishing mortality and enhancing survival quality.

关 键 词：脑出血 高血压 治疗 外科手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]