高血压脑出血立体定向微创软通道穿刺血肿引流术后再出血的原因及救治分析

Analysis of Rebleeding Caused by Stereotactic Mini-invasive Soft-Channel Puncture Hematoma Drainage after Hypertensive Intracerebral Hemorrhage

目的高血压脑出血立体定向微创软通道穿刺血肿引流术后再出血的原因及救治分析。方法方便选取该院2017年3月—2018年3月共186例高血压性脑出血患者作为研究对象,通过立体定向微创软通道穿刺血肿引流术进行治疗,观察术后再出血情况,并探讨其原因及救治策略。结果治疗后,痊愈113例,显效47例,有效13例,无效13例。共8例患者术后再出血,经对症治疗后均好转。结论脑血压脑出血立体定向微创软通道穿刺血肿引流术术后再出血的因素较多,例如穿刺时间、血压水平、首次抽吸量、甘露醇、长期酗酒、血肿形态、纤维蛋白原水平等。救治时应根据血肿的实际情况,适当选择再次手术或保守治疗。

Objective To analyze the cause and treatment of rebleeding after hematoma drainage by stereotactic microinvasive soft tract puncture for hypertensive intracerebral hemorrhage. Methods A total of 186 patients with hypertensive intracerebral hemorrhage from March 2017 to March 2018 in the hospital were convenient selected as study subjects. Stereotactic minimally invasive soft aspiration puncture hematoma drainage was used to treat postoperative rebleeding. The reason and treatment strategy were explored. Results After treatment, 113 cases were cured, 47 cases were markedly effective, 13 cases were effective, and 13 cases were ineffective. A total of 8 patients had rebleeding after surgery and all recovered after symptomatic treatment. Conclusion There are many factors of rebleeding after stereotactic soft-passage hematoma drainage for cerebral blood pressure cerebral hemorrhage, such as puncture time, blood pressure level, first aspiration volume, mannitol, long-term alcohol consumption, hematoma morphology, fibrinogen level. Healing should be based on the actual situation, the appropriate choice of reoperation or conservative treatment.