高血压小脑出血破入脑室手术治疗分析  

Analysis of surgical treatment for hypertensive cerebellar hemorrhage penetrating into the ventricle

作　　者：王向阳[1] 刘文彬[1] 韩冰[1] 王新厂[1] 冀战一 杨春华[2] WANG Xiangyang;LIU Wenbin;HAN Bing;WANG Xinchang;JI Zhanyi;YANG Chunhua(Department of Neurosurgery,First People’s Hospital of Zhengzhou,Zhengzhou 450004,China;Department of Neurology,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]郑州市第一人民医院神经外科,河南郑州450004 [2]周口市中心医院神经内科,河南周口466000

出　　处：《中国实用神经疾病杂志》2019年第15期1700-1707,共8页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨高血压小脑出血破入脑室的手术时机、手术方式及治疗体会。方法回顾分析郑州市第一人民医院2017-01—12收治的26例高血压小脑出血破入脑室患者的临床资料,3例单纯行脑室外引流术,15例单纯行枕下开颅血肿清除术,8例联合脑室外引流+枕下开颅血肿清除术。结果按GOS评分评价治疗效果,恢复良好16例,重度残疾5例,植物生存1例,死亡4例。结论小脑出血的手术应结合出血部位、出血量、脑积水情况及临床表现等综合考虑,尽早采取个体化手术方式。合理的手术时机和手术方式,可改善患者的预后。Objective To investigate the surgical time,surgical method and treatment experience of hypertensive cerebellar hemorrhage penetrating into the ventricle.Methods The clinical data of 26 patients with hypertensive cerebellar hemorrhage penetrating into the ventricle who were admitted to our hospital from January 2017 to December 2017 were retrospectively analyzed.3 patients underwent external ventricular drainage alone,15 patients underwent suboccipital craniotomy to remove the hematoma alone,and 8 patients underwent suboccipital craniotomy to remove the hematoma after external ventricular drainage.Results The therapeutic effect was evaluated by GOS score,16 patients recovered well,5 patients severe disabilities,1 patient vegetative state,4 patients died.Conclusion Based on the site of hematoma,volume of hematoma,hydrocephalus,and clinical features.Individualized surgery should be adopted as early as possible.Reasonable surgical time and method can improve the clinical outcomes.

关 键 词：高血压 小脑出血 颅内出血 手术 脑室外引流 

分 类 号：R743.34[医药卫生—神经病学与精神病学]