高血压脑出血开颅去骨瓣原因分析  

Analysis of the reasons of decompressive craniotomy in hypertensive cerebral hemorrhage

作　　者：杨晓勇[1] 林爱国[1] 刘小波[1] 何程[1] 周鸿伟[1] 魏厚禄[1] 唐宏图[1] Yang Xiaoyong;Lin Aiguo;Liu Xiaobo;He Cheng;Zhou Hongwei;Wei Houlu;Tang Hongtu(Department of Neurosurgery, The First People’Hospital of Suining, Suining, Sichuan, 629000, China)

机构地区：[1]遂宁市第一人民医院神经外科,四川遂宁629000

出　　处：《当代医学》2019年第8期82-84,共3页Contemporary Medicine

摘　　要：目的对高血压脑出血开颅手术是否去骨瓣的影响因素进行分析探讨。方法回顾性分析27例高血压脑出血开颅手术患者的临床资料,给予无创颅内压监测术前1 h、术后1 h、术后3 d的颅内压;分析引起术后颅内压的变化的影响因素。结果术前重度颅内高压18例,保留骨瓣组7例,术后3 d颅内压>30 mmHg,6例;去骨瓣组11例,术后3日颅内压>30 mmHg,3例,两者之间差异有统计学意义(c2=5.844,P=0.025<0.05)。术中损伤血管9例,保留骨瓣组3例,术后3日颅内压>30 mmHg 3例;去骨瓣组6例,术后3日颅内压>30 mmHg,1例,两者之间差异有统计学意义(c2=5.625,P=0.048<0.05)。结论去骨瓣减压能有效的缓解术后颅内高压,术前重度颅内高压和(或)术中有重要血管损伤者,应行去骨瓣减压。Objective To analyze the influencing factors of the decompressive craniotomy in hypertensive cerebral hemorrhage. Methods Retrospective analysis of clinical data of 27 patients with hypertensive cerebral hemorrhage after craniotomy, no invasive intracranial pressure monitoring was given 1 hours before operation, 1 hours after operation, and 3 days after operation. Analysis the influencing factors on the changes of intracranial pressure after operation. Results Preoperative severe intracranial hypertension in 18 cases, preserved bone flap group of 7 cases, third days after operation, intracranial pressure>30 mmHg in 6 cases;bone flap group of 11 cases, third days after operation, intracranial pressure>30 mmHg in 3 cases, there was a significant difference between the two groups (X^2=5.844, P=0.025<0.05);Intraoperative injury of blood vessels in 9 cases, preserved bone flap group of 3 cases, third days after operation, intracranial pressure>30 mmHg in 3 cases;bone flap group of 6 cases, third days after operation, intracranial pressure>30 mmHg in 1 cases, there was a significant difference between the two groups (X^2=5.625, P=0.048<0.05). Conclusion Decompression of the bone flap can effectively relieve postoperative intracranial hypertension, Preoperative severe intracranial hypertension and (or) patients with important vascular injury, should be treated with bone flap decompression.

关 键 词：脑出血 颅内压 去骨瓣 

分 类 号：R651.12[医药卫生—外科学]