高血压脑干出血显微手术治疗

Microsurgical Treatment of Hypertension Brainstem Hemorrhage

目的:探讨高血压脑干出血的显微外科治疗的手术指征、手术技巧、效果和预后。方法:回顾性分析21例高血压脑干出血患者的临床资料、手术方式、治疗效果及随访资料。结果:21例患者均于显微镜下清除血肿,无手术死亡,术中运用神经电生理监测。11例患者术后神经功能障碍得到改善,5例症状加重持续昏迷。5例术后死亡,术后随访6～18个月,9例生活基本能够自理,7例长期卧床。结论:采用显微外科技术治疗高血压脑干出血,效果良好。

Objective： To investigate the operation indication,technique,effectiveness and prognosis of microsurgical treatment of hypertension brainstem hemorrhage.Methods： A retrospective study was done on 21 patients with hypertension brainstem hemorrhage.The clinical presention,neuroradiological data,surgical approach,therapeutic efficacy and follow-up data were reviewed.Results： All of the cases were removed hematoma under microscope without death toll.Intraoperative electrophysiological monitoring of the floor of the fourth ventricle has been used.Postoperatively,the functional disorders of nervous system were improved in 11 cases.Five cases deteriorated and persistent coma after operation,five cases dead.Followed-up for six to eighteen months,nine cases were able to self-care with some efforts,and seven case was hemiparalysis or coma.Conclusion： Microsurgery is an effective treatment for hypertension brainstem hemorrhage with microsurgical technique.