脑干出血的外科治疗

Surgery for Brain Stem Hemorrhage

目的探讨脑干出血的手术治疗指征及处理方法。方法我科1998年至2005年共收治11例局灶性脑干出血病例均采用显微外科手术治疗。结果本组病人术后无死亡,无植物生存。1例术中出现窦性心动过缓,术后半年恢复;手术后面瘫加重3例,半年后2例完全恢复,1例有所改善。本组病人随访1～4年无再出血。结论脑干出血的显微外科手术治疗在细致的术前检查,严密的术中监护条件下,可以取得令人满意的结果。

Objective To explore the indication of surgical treatment and the technique of surgery for brainstem hemorrhage. Method Eleven patients with brainstem hemorrhage were treated by microneurosurgery in our department from 1998 to 2005. Results There were no death and persistent vegetative survivor in all the patients. The sinus bradycarbia appeared intraoperatrively and disappeared in 1 patient half year after the operation. Of 3 patients with facial paralysis deteriorated after the operation, 2 were totally recovered from the facial paralysis and 1 was improved in the facial paralysis half year after the operation. Following up from 1 to 4 years showed that the brainstem hemorrhage did not recurred in all the patients. Conclusion Under the precondition of meticulous preoperation examination and the rigorous supervision during the operation, the curative effect of microsurgery on brainstem hemorrhage is good.