38例高血压脑出血术后再出血临床分析  

Clinical analysis of resurgence hemorrhage of postoperative Hypertensive intracerebral hemorrhage in 38 cases

作　　者：陶杰 梅文忠[2] 林震涛[2] 

机构地区：[1]武夷山市立医院外科,353400 [2]福建医科大学附属第一医院神经外科,350005

出　　处：《福建医药杂志》2003年第4期31-33,共3页Fujian Medical Journal

摘　　要：目的　探讨高血压脑出血手术后再出血的原因及防治措施。方法　对 2 34例小骨窗开颅清除高血压基底节区血肿的病例进行临床资料总结。结果　高血压脑出血术后再出血发生率 16 .2 % (38/ 2 34) ,死亡率 4 7.4 %(18/ 38) ;再出血的主要临床表现为意识障碍加深及瞳孔变化 ,手术后血压仍持续增高且波动幅度大 ;89.5 % (34/38)再出血发生在手术后 2 4小时内。结论　再出血的主要原因为手术中止血不彻底以及手术后血压高且波动幅度大。术中妥善的止血和术后保持血压平稳是避免和减少再出血的关键因素。Objective\ To explore the causes of resurgence hemorrhage in postoperative hypertensive intracerebral hemorrhage and surgical management in clinical.Methods\ To summarize 234 cases which were done craniotomy with small cranial flap to remove hematoma in basal ganglion area.Results Incidence of resurgence hemorrhage in postoperation was 16 2%(38/234),mortality of the cases 47 4%(18/38) Main clinical manifestation resurgence hemorrhage was that the disturbance of consciousness was enhanced,pupils were altered and the blood pressure couldnt be controlled stably.89 5%(34/38)cases with resurgence hemorrhage occurred in 24 hours.Conclusion Main cause of Resurgence hemorrhage was not stanch bleeding entirely during operation and blood pressure of the patients was unstable perrion. After operation,key factor of preventing the resurgence hemorrhage is controlling bleeding properly during operation and keeping blood pressure in stable condition postoperation.

关 键 词：高血压脑出血 外科手术 术后 再出血 原因 防治 临床分析 

分 类 号：R651.12[医药卫生—外科学] R743.2[医药卫生—临床医学]