小骨窗显微手术结合无创颅内压监测治疗高血压脑出血  

The treatment of hypertensive cerebral hemorrhage by small bone window craniotomy connected with noninvasive measurement of intracranial pressure

作　　者：柳浩然[1] 徐利民[1] 吴海权[1] 辛续伟[1] 韩冬[1] 谢文贵[1] 李建华[1] 

机构地区：[1]广东公安边防总队医院神经外科,深圳518029

出　　处：《中国实用神经疾病杂志》2012年第20期12-13,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨小骨窗开颅显微手术结合无创颅内压(ICP)监测在高血压脑出血患者中的临床应用及可行性。方法选取55例高血压脑出血患者,采用小骨窗显微手术治疗,术后使用闪光视觉诱发电位(fVEP)进行无创颅内压监测,分析其治疗后的压力变化及疗效。结果术后存活53例,存活率96.3%,死亡2例。存活者日常生活能力分级:Ⅰ级7例,Ⅱ级29例,Ⅲ级12例,Ⅳ级3例,Ⅴ级2例。术后ICP在24～48h内有不同程度增高。结论小骨窗开颅显微镜手术结合无创颅内压监测治疗高血压脑出血,能有效清除血肿,降低病死率,改善患者病后日常生活能力,减少并发症,有临床应用价值。Objective To investigate the clinical application and feasibility of combination of small bone window cranioto- my and noninvasive measurement of intracranial pressure for the treatment of hypertensive cerebral hemorrhage. Methods To- tally 55 hypertensive cerebral hemorrhage patients were selected and treated with small bone window craniotomy. Noninvasive measurement of intracranial pressure was done by flash visual evoked potentials （fVEP） after operation. Then the efficacy and the change of intracranial pressure were analyzed. Results After treatment,53 patients were survival and 2 patients died whose survival rate was 96.3%. Survivors were graded by the activity of daily living. I degree of 7 patients, Ⅱ degree of 29 pa- tients, Ⅲ degree of 12 patients, IV degree of 3 patients and V degree of 2 patients. The ICP increased from 24 to 48 hours after operation. Conclusion As the treatment of hypertensive cerebral hemorrhage,the combination of small bone window cranioto- my and noninvasive measurement of intracranial pressure can effectively clean hematoma, degrade the fatality,improve the activ- ity of daily living after illness and reduce the complications. It has practical clinical applieal value.

关 键 词：无创颅内压监测 小骨窗显微手术 高血压脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]