儿童自发性脑出血24例的急救分析

Analysis on Emergency Treatment of 24 Cases of Spontaneous Intracerebral Hemorrhage in Children

目的:探讨儿童自发性脑出血24例的急救方法及效果。方法:选择本院2009年8月-2012年6月收治的儿童自发性脑出血患者24例,全部患者均经临床及影像学诊断确诊,均采取手术治疗,分析患者临床表现、病因、治疗效果及随访资料等。结果:本组24例患者中,脑动静脉畸形18例,治疗后显示畸形血管团消失16例,2例血管缩小,血管造影变暗,患儿全部存活。海绵体血管瘤4例,行海绵体血管瘤切除后复查提示血管瘤消失,患者存活;血液病2例,患儿术后死亡。存活22例患儿术后随访半年,显示患儿智力发育指数、体格指数与健康同龄儿20例相当,两者比较差异无统计学意义。结论:儿童自发性脑出血病情严重,脑动静脉畸形最常见,临床应尽早明确病因,及时行手术治疗,注意术后并发症,提高患儿存活率。

Objective：To investigate the emergency treatment and it’s effect on 24 cases ofspontaneous intracerebral hemorrhage in children. Method：Selecting 24 patients of children’s spontaneous intracerebral hemorrhage admitted by our hospital from August 2009 to 2012 June.All the patients confirmed by clinical diagnosis and imaging were taken to surgery.Exploring the clinical manifestations,etiology,treatment effect and data of follow-up. Result：In the group of 24 patients,18 cases were of cerebral arteriovenous malformation ,in which of them there were 16 cases of vascular malformation group disappeared,2 cases of vasoconstriction and angiography dimmed and all the children survived after treatment.4 patients of cavernous hemangioma underwent hemangioma resection survived,and the reexamination manifested that the hemangioma disappeared.2 patients of hematologic deseases of postoperative death.A 6 month followed-up of the 22 patients survived manifested that the patient’s mental and physical development index were lower than that of 20 healthy children at the same age,but there was no significant statistic difference.Conclusion：Children’s spontaneous intracerebral hemorrhage condition is serious,which is often caused by cerebral arteriovenous malformation.It’s necessary to confirm the etiology,take appropriate surgery as soon as possible and prevent operative complications,which are important for improving the survival rate of children.