自发性小脑出血的外科治疗选择

Selection of Surgical Way to Treat Spotaneous Cerebellar Hemorrhage

目的探讨自发性小脑出血的外科治疗方式。方法回顾性分析我院采用不同手术方式治疗的31例自发性小脑出血患者的临床资料。结果采用后颅窝开颅血肿清除及去骨瓣减压术治疗19例,其中恢复良好12例,重残4例,植物生存1例,死亡2例;采用CT引导立体定向血肿穿刺引流术治疗7例,其中恢复良好5例,重残1例,死亡1例;采用单纯脑室外引流治疗5例,其中恢复良好4例,重残1例。结论对自发性小脑出血患者,要根据发病时间、病因、病情轻重、头颅CT表现,选择不同的手术方式;及时手术治疗可以取得良好的治疗效果。

Objective To explore the surgical way to treat spotaneous cerebellar hemorrhage（SCH）. Methods The clinical data of 31 patients with SCH, who were treated by different operative ways in our hospital, were analyzed retrospectively. Of 31 patients with SCH, 19 underwent craniotomy for evacuation hematomas and removal of skull bone flaps for decompression, 7 CT-guided stereotaxic puncture and drainage of hemotomas and 5 only external restricular drainage. Results Of 19 patients undergoing cranioptomy, 12 were recovered well, 4 were severely disabled, 1 survived vegetatively and 2 died. Of 7 undergoing CT-guided puncture and drainage, 5 were recovered well, 1 was severely disable and 1 died. Of 5 undergoing external ventricular drainage, 4 were recovered well, and 1 was severely disabled. Conclusions The surgical way should be selected according to the time and cause of hemorrhage, degree of patients＇ conditions severity and CT imaging of hemorrhage in the patients with SCH. The curative effect of timely proper surgery on the patients with SCH is good.