显微手术在高血压小脑出血中的临床应用

Efficacy of microsurgery for the hypertensive spontaneous cereballar hemorrhage

目的探讨显微外科手术在高血压小脑出血的手术时机、手术方法及治疗效果。方法对23例高血压小脑出血患者的显微手术治疗结果进行回顾性分析。结果 23例患者术后复查头颅CT示血肿清除量>90%者16例,5例行侧脑室外引流术,死亡5例,18例术后ADL分级:I级6例、Ⅱ级4例、Ⅲ级4例、Ⅳ级3例、V级l例。结论对高血压小脑出血进行显微手术治疗时,应根据患者的意识状态、出血量、脑干受压程度及伴有或不伴有梗阻性脑积水等综合评估,术中有效清除血肿,可取得良好的疗效。

Objective To investigate the operative indications,microsurgical approachs and results of hypertensive cerebellar hemorrhage. Methods To study the clinical results of 23 cases of hypertensive cerebellar hemorrhage, Their clinical features, outcomes, follow--up and operative complications were analyzed. Results A tolal of 23 patients were treated surgically, postoperative CT scans revealing〉90% disappearance of the hematoma were in 16 cases, 5 cases required ven- tricular drainage, 5 cases were dead. Outcomes were assessed by the ADL：6 cases were Ⅰ,4 cases were Ⅱ1 , 4 cases were Ⅲ, 3 cases were Ⅳ, 1 case was Ⅴ. Conclusion Neurological status, hemato- ma volume, brainstem compression, and obstructive hydrocephalus are the important factors on which to be assessed. Thorough cleaning of the hematoma,operative efficacy is satisfied.