外科治疗脑室出血的临床分析研究

Surgical treatment ventricle bleeding clinical analysis research

目的:总结基底节、丘脑出血破入脑室出血适当的治疗方法的效果。方法:根据基底节、丘脑出血破入脑室出血的多少、铸造程度、患者意识情况、脑干及丘脑受损情况采取不同的治疗方法。基底节出血破入脑室微创手术必须在脑水肿高峰前打通脑脊液外引流,丘脑出血极易破入脑室损害脑干及丘脑功能,急性脑积水,加重中枢损害,微创手术的穿刺点应选在直接进入丘脑血肿中心,最快解决血肿对丘脑的进一步损害。结果:患者年龄过大,伴有多脏器功能损害,入院时已处于脑室血肿造成的脑疝晚期,出现呼吸、循环衰竭征象、高热、肺部感染并发症严重,手术不能改变病情。结论:微创早期清除血肿解除脑干、丘脑受压,引流脑脊液置换大大提高生存率,减少死亡率。

Objective： Summary of basal ganglia,broken into the thalamus bleeding ventricles bleeding an adequate treatment effect.Methods： According to the basal ganglia,thalamus bleeding broken into the ventricle bleeding in patients with how much,casting,degree of consciousness,and thalamus damage situation brainstem adopt different treatment methods.The basal ganglia bleeding broken into the ventricle minimally invasive surgery must in cerebral edema peak before external drainage,thalamus cerebrospinal fluid through easily broken into the ventricle damage bleeding and thalamus function,acute brainstem hydrocephalus,aggravating central damage,minimally invasive surgery puncture point elected in directly into the thalamus hematoma center,the fastest solution to the thalamus hematoma further damage.Results： Patients age too large,accompanied by multiple organ dysfunction,admission was already in ventricle hematoma caused by cerebral hernia,occurrence breath,adanced circulation failure signs,high fever,lung infection severe complications,surgery could not change of the illness.Conclusion： Minimally invasive early removal hematoma remove brainstem,thalamus under pressure,drainage cerebrospinal fluid displacement greatly improve survival,reduce mortality.