球囊脑造通辅助显微手术治疗高血压性脑出血的疗效分析  

Microsurgery through cerebral corridor created by sacculus for patients with hypertensive cerebral hemorrhage

作　　者：殷志林 樊晶鑫 谭一虎 卢俊章 胡腾华 王少兵 陈坚[2] YIN Zhi-lin;FAN Jin-xin;TAN Yi-hu;LU Jun-zhang;HU Teng-hua;WANG Shao-bing;CHEN Jian(Department of Neurosurgery,Hubei Provincial Hospital of Integrated Chinese and Western Medicine,Wuhan 430015,China;Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]湖北省中西医结合医院神经外科,武汉430015 [2]华中科技大学同济医学院附属同济医院神经外科,武汉430030

出　　处：《中国临床神经外科杂志》2021年第7期521-523,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨球囊脑造通辅助显微手术治疗高血压性脑出血的效果。方法回顾性分析2018年9月~2020年6月应用球囊脑造通辅助显微手术治疗的58例高血压性脑出血的临床资料。术后24 h复查头部CT,计算血肿清除率;术后随访6个月,采用GOS评分评价预后,4~5分为预后良好。结果术后24 h复查头部CT,血肿清除率>90%有40例,80%~90%有15例,60%~80%有3例;平均血肿清除率为(91.8±6.7)%。术后无死亡、颅内感染、脑积水并发症,术后出现再出血2例、肺部感染7例、硬脑膜下积液3例;并发症总发生率为21.4%(12/56)。术后56例随访6个月,恢复良好14例,中残23例,重残13例,植物生存6例;预后良好率为66.1%(37/56)。结论球囊脑造通辅助显微手术治疗高血压性脑出血创伤小,效果良好。Objective To investigate the clinical efficacy of microsurgery through cerebral corridor created by sacculus for the patients with hypertensive cerebral hemorrhage(HCH).Methods The clinical data of 58 patients with HCH who underwent microsurgery through cerebral corridor created by sacculus from September 2018 to June 2020 were analyzed retrospectively.Results Hematoma clearance rate>90%was achieved in 40 patients,80%~90%in 15 and 60%~80%in 3 according to the 24-hour postoperative CT images.The average clearance rate was(91.8±6.7)%.Six-month follow up was performed on 56 patients of whom 14 patients had GOS scors of 5,23 had GOS score of 4,13 patients had GOS score of 3,and 6 patients had GOS score of 2.The rate of good prognosis(GOS score of 4~5)was 66.1%(37/56).There was no death,intracranial infection and hydrocephalus.The total incidence of postoperative complications was 21.4%(12/58),including 2 pateints with rebleeding,7 patients with pulmonary infection and 3 patients with subdural effusion.Conclusions Microsurgery through cerebral corridor created by sacculus,which has the advantages of small trauma and good clinical effcacy,is a good treatment method for the patients with HCH.

关 键 词：高血压性脑出血 球囊脑造通 显微手术 疗效 

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]