颅内血肿清除术并发脑梗死治疗经验总结

Experience of intracranial hematoma removal with cerebral infarction

目的总结分享颅内血肿清除术并发脑梗死的治疗经验。方法回顾性分析济宁医学院附属金乡医院神经外科自2010年6月至2017年12月收治的22例行颅内血肿开颅手术并发脑梗死患者的临床资料,对其治疗和结果进行总结。结果 22例患者中,术后即刻或24 h内复查颅脑CT,术后患者死亡7例,重残3例,轻残5例,基本正常7例。术后3~7 d复查颅脑CT,显示低密度区局部可见脑回密度,其中大脑中动脉供血区梗死1例,大脑后动脉供血区梗死基本均恢复,大脑半球梗死患者未见脑供血恢复情况。结论提早发现颅内血肿清除术并发脑梗死的高风险因素,可大幅提高抢救的成功率,降低患者致死致残率。

Objective To summarize the experience of treating intracranial hematoma complicated with cerebral infarction. Methods A retrospective analysis of the clinical data, treatment and results of 22 patients of intracranial hematoma treated by craniotomy from June 2010 to December 2017 in the Department of Neurology, Jinxiang Hospital Affiliated to Jining Medical College. Results Twenty-two patients rechecked CT after operation within 24 h, 7 patients died, 3 patients severe disability, 5 patients mild disability, and 7 patients were normal. On the 3-7 d after the operation, the cerebral CT showed that the density of the cerebral gyrus localized in the low density region, 1 patient infarcted in the middle cerebral artery, the infarcts in the posterior cerebral artery were basically recovered, and the cerebral hemisphere infaction patients did not cure of blood supply. Conclusion Early detection of the high risk tactors of cerebral infarction associated with intracranial hematoma removal can greatly increase the success rate of rescue and reduce the death and disability rate of patients.