高血压脑出血围手术期的处理

Perioperative Management of Hypertensive Cerebral Hemorrhage

探讨高血压脑出血围手术期的处理原则和治疗要点。方法复习和研究３２例高血压脑出血围手术期处理的资料。结果术后死亡６例，均为术前中、深度昏迷者，２６例生存者中肢体肌力恢复到３～４级、并可从事轻的工作７例，恢复到可自理生活１２例，轻偏瘫、生活需家人照顾者５例，术后仍偏瘫、生活不能自理２例。结论高血压脑出血围手术期的处理至关重要，注意手术时平稳的麻醉诱导，严格的呼吸管理，积极预防颅内压增高、肺炎、消化道出血、心脏损害等。可以提高疗效和术后生存质量。

Objective\ To improve the surgical curative effect of hypertensive cerebral hemorrhage.\ Methods\ To review and study perioperative management of 32 cases of hypertensive cerebral hemorrhage.\ Results\ 6 cases died postoperatively,7 patients’ myodynamic recovered to grade 3～4 and could undertake light work,12 cases could be self reliable,2 cases were still hemiplegic and couldnot help themselves.\ Conclusions\ Perioperative handling such as preoperative stable anesthesia induction,stable respiratory management,actively taking precautions against intracranial hypertension,pneumonia,digestive tract hemorrhage and heart involvement were crucial,then the curative rate and postoperative survival quality can be improved.