高血压脑出血脑疝72例手术疗效分析  

CURATIVE EFFECTIVENESS OF 72 CASES OF CEREBRAL HERNIA OF HYPERTENSIVE CEREBRAL HEMORRHAGE

作　　者：孙茂林[1] 陈大刚[1] 

机构地区：[1]黑龙江省齐齐哈尔医学院第三附属医院,齐齐哈尔161000

出　　处：《现代预防医学》2012年第3期792-793,共2页Modern Preventive Medicine

摘　　要：[目的]探讨高血压脑出血脑疝的手术效果和影响因素。[方法]72例双侧瞳孔散大高血压脑疝的患者,按出血部位分组并接受手术治疗,于手术后半年进行格拉斯哥评分(GCS)。[结果]全组恢复良好6例,中残11例,重残10例,植物生存9例,死亡36例,其中皮层出血组预后最好,小脑组最差,其差异有统计学意义(P﹤0.05)。[结论]高血压脑出血性脑疝的手术疗效与出血部位密切相关,皮层出血所致的晚期脑疝应积极手术治疗,预后较佳;小脑出血致晚期脑疝,手术意义不大;壳核及内囊内侧出血导致的晚期脑疝经手术治疗仍有可能挽救生命。另外,快速准确的诊断,恰当的术式选择和围手术期处理是救治成功的必要保证.[Objective]To investigate the effectiveness of cerebral hernia and hypertensive intracerebral hemorrhage and its impact factors.[Methods]72 cases of bilateral mydriasis in hypertension hernia patients were grouped according to the bleeding site and given surgery.In six months after surgery,Glasgow score（GCS）was used.[Results]There were 6 cases in good recovery,11 cases of residual,10 cases of severe disability,9 cases of vegetative,36 cases died,in which the best prognosis was in cortical hemorrhage group,the worst in cerebellar group,the differences were statistically significant（P﹤0.05）.[Conclusion]The surgery effect of hernia of hypertensive intracerebral hemorrhage is closely related to the bleeding site.Cerebral hernia due to cortical hemorrhage should be treated positively,the prognosis is better;surgery for late cerebral hernia because of cerebellar hemorrhage is meaningless;late cerebral hernia caused by putamen and internal capsule hemorrhage could be treated by surgery.In addition,rapid and accurate diagnosis,appropriate surgery and perioperative management are necessary to ensure successful treatment

关 键 词：高血压脑出血 瞳孔散大 脑疝 手术 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]