高血压性脑干出血的个体化手术治疗  

Individualized surgical treatment based on volume and location of hemotoma for hypertensive brainstem hemorrhage

作　　者：陈静[1] 滕晓华[1] 向健威 刘宇[1] 张佳兴 姜峰[1] 张汀琼 杜进兵 CHEN Jing;TENG Xiao-hua;XIANG Jian-wei;LIU Yu;ZHANG Jia-xing;JIANG Feng;ZHANG Ting-qiong;DU Jin-bing(Department of Neurosurgery,The 921st Hospital of Joint Logistics Force,PLA,Changsha 410003,China;Medical Service Department,General Hospital of Central Theater,PLA,Wuhan 430070,China)

机构地区：[1]中国人民解放军联勤部队第921医院神经外科,长沙410003 [2]中国人民解放军中部战区总医院卫勤部,武汉430070

出　　处：《中国临床神经外科杂志》2020年第4期218-220,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨高血压性脑干出血的显微手术治疗的手术指征、手术技巧、手术方法和预后。方法回顾性分析2011年1月至2018年12月收治的54例高血压性脑干出血的临床资料。根据出血量及出血部位采用个体化手术治疗。结果术后3个月,按GOS评分:脑室穿刺治疗的30例中,8例恢复良好,12例中残或重残,4例植物状态生存,6例死亡;开颅手术治疗的20例中,3例恢复良好,5例中残或重残,5例植物状态生存,7例死亡;脑干穿刺治疗的4例中,中残2例,重残1例,植物状态生存1例。结论根据出血量及出血部位采用不同的方法治疗高血压性脑干出血,效果良好。Objective To explore the surgical indications,surgical techniques,surgical methods and surgical efficacy for hypertensive brainstem hemorrhage.Methods The clinical data of 54 patients with hypertensive brainstem hemorrhage who were admitted to our hospital from January 2011 to December 2018 were retrospectively analyzed.According to the volume and location of hemotoma,individualized surgical treatment was used.The prognosis was assessed according to the GOS score 3 months after the operation.Results Of 30 patients treated with ventricular puncture,8 patients were recovered well,12 were moderately or severely disabled,4 survived in vegetative state,and 6 died.Of 20 patients treated with craniotomy,3 patients were recovered well,5 were moderately or severely disabled,5 survived in vegetative state,and 7 died.Of 4 patients treated with brainstem puncture treatment,2 were moderate disability,1 was severe disability,and 1 was vegetative state.Conclusion For hypertensive brainstem hemorrhage,the treatment method should be chosen according to the volume and location of the homatoma,which can obtain good clinical effects.

关 键 词：高血压性脑干出血 显微手术 手术指征 手术方法 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]