小骨窗开颅术延期清除幕上自发性脑内血肿12例临床分析  

A clinical analysis on delayed hematoma evacuation for supratentorial spontaneous intracerebral hemorrhage by small-bone-window craniotomy

作　　者：纪祥军[1] 王汉东[1] 杭春华[1] 樊友武[1] 叶振南[1] 刘景鹏[1] 茅磊[1] 

机构地区：[1]南京军区南京总医院神经外科,江苏省210002

出　　处：《江苏医药》2016年第4期399-401,共3页Jiangsu Medical Journal

基　　金：江苏省自然科学基金青年基金(BK20140731)

摘　　要：目的探讨小骨窗开颅术延期清除幕上自发性脑出血的效果。方法对12例幕上自发性脑内血肿患者进行小骨窗开颅术清除血肿,血肿量为（45.8±14.6）ml,手术距出血时间为1-7d;患者术前GCS评分均≥8分。术后随访3个月,评估疗效。结果延期手术时,脑内血肿较为稳定,且血肿与周围脑组织界限更分明,血肿更易于清除。9例血肿清除率〉90%,3例为83.9%-87.1%,无死亡病例。术后GOS、GCS和KPS评分均较术前明显改善。结论对于GCS评分≥8分的幕上自发性脑出血患者,延期手术可能更有益于血肿的清除和脑组织保护。Objective To investigate the outcomes of delayed hematoma evacuation for supratentorial spontaneous intracerebral hemorrhage（ICH）by the small-bone-window craniotomy.Methods Delayed hematoma evacuation was performed in 12 patients with supratentorial ICH and the patients were followed up for 3 months.The hematoma volume was（45.8±14.6）ml in average and the time for surgery ranged from 1to 7days after stroke.The GCS score was greater than or equal to 8 points.The outcomes were analyzed.Results The evacuation rate of ICH was higher than 90% in 9 cases and 83.9%-87.1% in the rest 3 cases without death case.The GOS grades and the scores of GCS and Karnofsky performance scale were all improved significantly after hematoma evacuation.Conclusion Delayed hematoma evacuation via small-bone-window craniotomy may be more safe and efficient for the patients with supratentorial spontaneous ICH with GCS≥8 points.

关 键 词：小骨窗开颅术 自发性脑内出血 

分 类 号：R651[医药卫生—外科学]