颅内血肿微创手术及亚低温脑保护的临床研究

Minimally Invasive Surgery for Intracranial Hematoma and Clinical Study of Protective Effect of mild Hypothermia on Brain

目的 探讨颅内血肿微创手术的优越性及围手术期亚低温脑保护的临床效果。方法 对100例内血肿病人围手术期亚低温脑保护同时予以微创血肿清除术。其中外伤性颅内血肿53例,高血压性脑内血肿40例,自发性脑内血肿(脑动静脉畸形或脑动脉瘤)7例。结果 术后半年随访内血肿ADL1(社会生活能力正常)37例,ADL2(有自理生活能力)25例,ADL3(部分生活处理)26例,ADL4(卧床)7例,ADL5(植物生存)2例,死亡3例。结论 颅内血肿微创手术,创伤小、安全。而围手术期亚低温脑保护,对降低死亡率、提高患者术后生存质量有很多重要意义。

Objective To evaluate the advantages of minimally invasive surgery for treatment of intracranial hematoma, and clinically the brain-protective effects of mild hypothennia during the perioperative period. Method Retrospective analysis of the data from 100 patients with intracranial hematoma, who had received minimally invasive operation and mild hypothermia treatment during the perioperative period. Results The results of 6 - month follow-up showed that complete recovery was achieved in 37 cases (ADL1), complete self-care in 25 (ADL2) and partial in 26 (ADL3) . Seven patients were confined to their bed (ADL4) but conscious, 2 remained unconscious and 3 died. Conclusion The minimally invasive surgery adopted for treatment of intracranial hematoma has its advantages such as less traumatic, reliable and safe. The authors considered that when this surgery is combined with mild hypothennia treatment, the significant advantages are as follows: it is helpful to protect the brain tissues, lower the mortality and improve the post - operative life quality of the patients.