自发性脑干出血手术治疗的现状与展望  

Current situation and prospect of surgical treatment for spontaneous brainstem hemorrhage

作　　者：柴双 刘耀华 Chai Shuang;Liu Yaohua(Department of Neurosurgery,Zalantun Sino-Mongolian Hospital,Zalantun 162650,China;Department of Neurosurgery,Shanghai General Hospital of Shanghai Jiaotong University,Shanghai 200080,China)

机构地区：[1]内蒙古自治区扎兰屯市中蒙医院脑外科,162650 [2]上海交通大学附属第一人民医院神经外科,200080

出　　处：《中国综合临床》2021年第5期462-466,共5页Clinical Medicine of China

基　　金：国家自然科学基金资助项目(81372701)。

摘　　要：自发性脑干出血发病率约为原发性脑出血的10%,但其病死率和致残率远高于其他疾病。脑干解剖特点及密集的功能核团与脑干出血手术极高的操作难度有着密不可分的关系。原发性脑干出血的手术治疗方式主要分为开颅血肿清除、血肿穿刺抽吸两类。目前对于脑干手术治疗的适应证尚未形成共识,缺乏大型多中心临床观察结果和循证医学证据的支持。现有的治疗方式均未在脑干出血治疗上取得突破性进展,医师在临床工作中常由于缺乏依据而困惑,寻求脑干出血的有效治疗方式具有积极的意义。The incidence of spontaneous brainstem hemorrhage is about 10%of primary intracerebral hemorrhage,but its mortality and disability rate are much higher than other diseases.The anatomical characteristics and dense functional nuclei of the brain stem are closely related to the high difficulty of operation for brain stem hemorrhage.The surgical treatment of primary brain stem hemorrhage is divided into two types:craniotomy hematoma removal and hematoma aspiration.At present,there is no unified consensus on the surgical indications for brainstem surgery,and the support of large-scale multicenter clinical observation results and evidence-based medicine evidence is lacking.None of the existing treatment methods has made a breakthrough in the treatment of brainstem hemorrhage,and doctors are often confused because of the lack of evidence in clinical work.It is of positive significance to seek an effective treatment for brainstem hemorrhage.

关 键 词：脑干出血 手术治疗 临床特点 预后 

分 类 号：R651.12[医药卫生—外科学]