高血压脑出血术后再出血原因分析及防治对策

Analysis of the Causes and Prevention and Treatment of Hypertensive Cerebral Hemorrhage after Operation

目的探索高血压脑出血术后再出血原因及防治对策。方法选取2015年5月—2016年5月在该院住院手术治疗高血压脑出血的76例患者,术后发生再出血16例,对住院病例进行回顾与分析,总结其再出血原因并给予相应的防治对策。结果通过统计数据发现发生高血压脑出血术后再出血患者12例,发生率为21.05%,其中2例患者不配合擅自出院导致手术治疗术后24 h内死亡,发生率为2.63%,同时术后记录患者临床表现发现患者双侧瞳孔大小变化、意识轻微障碍、血压波动不定等。结论通过分析导致术后再出血术原因与术者术中操作、患处止血不当以及术前是否使用凝血药、手术选择时机错误有关,但患者术后的体温、血压、患者情绪也有一定关系。高血压脑出血术后在出血可能与临床手术方式和术中操作以及患者术后生命体征检测和情绪有关,临床应合理使用降压、镇静、抗凝血药物,同时实时检测患者术后生命体征。

Objective To explore the causes and prevention measures of hypertensive cerebral hemorrhage after operation.Methods From May 2015 to May 2016 in our hospital 76 cases of surgical treatment of patients with hypertensive cerebral hemorrhage, 16 cases of postoperative rebleeding of hospitalized cases, review and analysis, summarize the causes of rebleeding and give the corresponding countermeasures. Results Through the statistical data found 12 patients with rebleeding after operation of hypertensive cerebral hemorrhage, the incidence rate was 21.05%, of which 2 patients did not leave the hospital with surgical treatment lead to death within 24 h after the operation, the incidence rate was 2.63%, and the postoperative records found in patients with clinical manifestations of patients with bilateral pupillary changes, consciousness disorder, slight fluctuations in blood pressure is not etc. Conclusion By analyzing the cause of causes and operation postoperative bleeding in operation in the operation, the affected area and whether preoperative hemostatic improper use of clotting drugs, surgery timing error, but the postoperative body temperature, blood pressure, patients also have a certain relationship.After operation of hypertensive cerebral hemorrhage in the bleeding may be associated with clinical surgery and intraoperative operation and postoperative vital signs and emotions, the clinical reasonable use of antihypertensive, sedation, anti clotting drugs, and real-time detection of the patients vital signs.