微创治疗基底节区内侧型高血压脑出血36例报道

MICROSURGERY TO TREAT 36 CASES OF MEDIAL HYPERTENSIVE CEREBRAL HEMORRHAGE IN BASILAR AREA

目的探讨微创治疗内侧型高血压脑出血的临床效果。方法选择内侧型高血压脑出血患者36例,采用局部麻醉,头皮3 cm长直切口,颅骨钻孔,切开硬脑膜,硅胶管穿刺血肿并抽吸,硅胶管置于血肿腔内,便于术后血肿腔内注射尿激酶并引流,合并破入脑室者行脑室外引流。结果25例术前未脑疝患者术后无1例死亡;11例术前出现脑疝者5例死亡,死亡原因:3例呼吸循环衰竭,1例肺部感染呼吸衰竭,1例营养不良、多器官功能衰竭。结论微创技术是一创伤小,效果好,安全简便的治疗内侧型高血压脑出血的方法。

Objective To explore the curative effects of mirosurgery on medial hypertensive cerebral hemorrhage（MHCH）. Methods 36 cases of MHCH underwent local anaesthesia and microsurgery, 3cm-long incision was made on scalp and trephination was performed on cranial bone. The dura mates was cut open and punctilre was performed with silica gel tube to conduct suction of hematoma. The silica gel tube was place in the hematoma to make urokinase injection and drainage easy to conduct, and ventriculostomy was performed. Results None of the 25 cases without cerebral hernia before operatiors died. 5 cases of the 11 cases with hernia before operation died because of respiratory circulatory failure in 3 cases, pulmonary infection and respiratory failure in one case and malnutrition and multiple organ failure in one case. Conclusion Microsurgery can be effectively used to treat medial hypertensive cerebral hemorrhage.