小脑出血44例临床分析及治疗选择

Clinical analysis of 44 patients with cerebellar hemorrhage and the selection of treatment

目的 :研究小脑出血的病因、临床症状、CT或 MRI表现及治疗选择和预后。方法 :总结分析 44例小脑出血患者的临床表现、CT或 MRI资料、回顾性的应用神经功能缺损评分于治疗方法选择 ,评估疗效及预后。结果 :本病多见于老年患者 (>6 0岁 ) ,以高血压动脉硬化为主要病因 ,中青年患者 (<40岁 )多以动静脉畸形为主要病因 ,治疗的选择需根据神经功能缺损评分标准评分情况并结合 CT或 MRI显示的血肿量来决定 ,并直接关系到患者预后。结论 :小脑血肿量 <15 ml且评分为轻—中型的患者无论内、外科治疗均预后良好 ,血肿量≥ 16 ml且评分为重型患者 ,宜选择外科手术治疗。

Objective:To study the cause of cerelellar haemorrhage, the clinical symptoms, the CT or MRI material, the selection of treatment and prognosis. Methods: Summerized and analyzed the clinical appearance and the CT or MRI material of the 44 cerebellar hemorrhage patients, retrospectively applied the Chinese scale of clinical neurologic deficit to the selection of treatment, then evaluated the effect and the prognosis. Results:Cerebellar hemorrhage mainly ocurred in elderly peoply (>60years), hypertension and arteriosclerosis were the main cause of the disease. Arterio veinous malformation (AVM) was the main cause in the gouth and the middle aged. The selection of the treatment must be determined by the scale accompanied with the hematoma volume, and it directly related to the prognosis.Conclusion: No matter what kinds of treatment the patients with a hematoma volume less than 15ml and a slighy medium type of the scale took, they had a rather good prognosis; if the hematoma volume was larger than 16ml and with a severe type of the scale, it's better to take the meurosurgical operation.