超早期经脑沟显微手术治疗高血压基底节区脑出血31例  

Ultraearly treatment of hypertensive basal ganglia cerebral hemorrhage by sulci microsurgery in 31 cases

作　　者：方钧[1] 许令明[1] 张道兵[1] 蒋昌政 叶昀[1] 陈劲松 申兆磊 FANG Jun;XU Ling-ming;ZHANG Dao-bing(Shucheng County People's Hospital,Shucheng 231300,Anhui)

机构地区：[1]舒城县人民医院神经外科,安徽舒城231300

出　　处：《安徽卫生职业技术学院学报》2020年第6期34-35,37,共3页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:探讨超早期经脑沟显微手术治疗基底节区高血压脑出血的临床疗效。方法:回顾性分析31例确诊高血压基底节区脑出血的手术治疗,均在发病后6 h内接受开颅经脑沟显微下血肿清除的治疗,其中合并脑疝患者行大骨瓣开颅,无脑疝患者采用弧形切口小骨窗开颅,术中根据脑压情况,决定是否去骨瓣,术后常规予以止血,预防癫痫等治疗。结果:31例手术均顺利完成,平均手术时间(100.6±23.2)min,手术中均未输血,分别于术后即刻、24 h、72 h及7 d复查CT,血肿清除均达90%以上,无1例再出血。术后1个月后根据GOS标准评估生存质量,优5例,良8例,中10例,差5例。结论:高血压脑出血患者病死率和致残率较高,经脑沟显微手术治疗超早期基底节区脑出血,具有创伤及医源性损伤小,手术时间短,止血确实可靠的优点,值得基层医院推广。Objective:To investigate the clinical effect of ultraearly transsulcus microsurgery in the treatment of hypertensive cerebral hemorrhage in basal ganglia region.Methods:A retrospective analysis of 31 cases confirmed in the surgical treatment of hypertensive basal ganglia hemorrhage,both within 6 h after the onset of who underwent the treatment of brain ditch under microscopic hematoma removal,the combination of cerebral hernia patients with large bone flap craniotomy,patients with cerebral hernia arc incision small bone window craniotomy,intraoperative brain pressure according to the situation,to decide whether to go to bone flap,the postoperative routine to stop bleeding,prevention of epilepsy treatment.Results:All the 31 cases were successfully completed with an average operation time of(100.6±23.2)min.No blood transfusion was performed during the operation.CT reexamination was conducted immediately after the operation,24 h,72 h and 7 d,respectively.Postoperative 1 month after according to GOS standard assessment of quality of life,in 5 cases,8 cases,10 cases,5 cases.Conclusion:The mortality and morbidity of hypertension cerebral hemorrhage patients is higher,the super early basal ganglia hemorrhage,brain ditch microsurgery treatment of trauma and iatrogenic injury of small,short operative time,bleeding the advantages of reliable,which is worth popularizing in basic-level hospitals.

关 键 词：显微手术 高血压 基底节区 脑出血 

分 类 号：R743.2[医药卫生—神经病学与精神病学]