高血压脑出血手术治疗130例临床分析

Clinical aralysis of 130 cases: the surgery treatment of cerebral hemorrhage caused by hypertension

目的研究探讨高血压脑出血患者的手术诊疗方法。方法根据出血量和出血部位以及临床表现,采用开颅清除血肿术和微创血肿穿刺清除术对130例高血压脑出血患者进行治疗。结果使用不同的手术方法治疗以后,此130例患者中恢复工作能力的有15例,生活能够自理的54例,需要照顾患者有29例,死亡的23例。结论对于出血量较大和临床表现较重以及部位靠近内囊外侧者宜采用传统额颞开颅,去骨瓣减压术;如果出血量在30mL以下,临床表现比较轻,宜采用小骨窗微创开颅手术;对于原发性脑室出血则以额角钻孔脑室外引流术较为合适。采用不同的手术方法来治疗高血压脑出血对于术后患者病情的恢复和减少并发症有重要意义。

Objective To study the diagnosis and treatment of patients with hypertensive cerebral hemorrhage operation method. Methods According to the amount of bleeding and bleeding site and clinical manifestations, the craniotomy for removal of hematoma and minimally invasive hematoma removal in 130 cases of hypertensive cerebral hemorrhage patients treated with. Results The results using different operation method after treatment, the130 patients regained work ability of 15 patients,54 patients living independently, need to take care of patients with 29cases,23 deaths. Conclusion The bleeding amount is larger and heavier parts of clinical manifestations and close to the internal capsule lateral should adopt the traditional frontotemporal craniotomy, decompressive craniectomy; if the amount of bleeding in the following 30 ml, comparative clinical performance of light, should adopt the keyhole minimally invasive craniotomy operation; for primary intraventricular hemorrhage by ventricular drainage on the borehole is more appropriate. Use different operation method to treat hypertensive cerebral hemorrhage patients for postoperative recovery and less complication is important.