高血压小脑出血的外科治疗

Surgical Treatment of Hypertensive Cerebellar Hematoma

目的:探讨高血压小脑出血的手术指征及手术方式。方法:回顾性分析我科63例经手术治疗的高血压小脑出血患者的临床资料及手术方式。结果:单纯脑室外引流术(第一组)8例,术后死亡2例,6个月后随访5例,Barthel指数均在70分以上;枕骨开窗血肿清除术(第二组)15例,术后死亡1例,余14例6个月后Barthel指数均在70分以上;环枕减压及血肿清除术(第三组)40例,术后死亡5例,6个月后29位患者得到随访,Barthel指数在70分以上者有24例。结论:对高血压小脑出血患者,要根据年龄、发病时间、病情轻重、头颅CT表现选择不同的手术方式。

Objective:To study the operative indication and method in the treatment of hypertensive cerebellar hematoma.Method:Retrospectively analyzed the clinical data and operative methods of 63 hypertensive cerebellar hematomas.Result:Eight cases were operated by simple external ventriclostomy of which 2 died postoperatively.Barthel index of the 5 cases who were followed up were all above 70 scores after six months;15 cases were treated by occipital bone window and hematoma evacuation,of which 1 died postoperatively.Barthel index of the 14 cases who were followed up were above 70 scores after six months and 40 cases treated by atlanoccipital decompression and hematoma evacuation,of which 5 died postoperatively.24 Barthel indexes of the 29 cases had followed up for six months after operation,of which the Barthel in dexes of 24 were above 70 seeres.Conclusion:As to the patients with hypertensive cerebellar hematomas,we should select appropriate operative method according to their age、attack duration、severity of the patients condition and head CT manifestation.