基底节区脑出血微创术后并发大面积脑梗死12例临床分析

Clinical analysis of 12 cases of massive cerebral infarction after minimally invasive surgery in basal ganglia hemorrhage

目的探讨脑出血微创锥颅术后并发大面积脑梗死的病因及预防治疗措施。方法选取2010年1月至2014年10月基底节区脑出血患者12例,男4例,女8例,年龄50～80岁。12例患者出血量为30～70 ml,均给予微创锥颅血肿引流术,根据脑CT图像,描述脑出血和大面积脑梗死,并给予相应治疗。讨论脑出血微创锥颅术后并发大面积脑梗死的危险因素及预防治疗措施。结果 12例患者中死亡2例,家属自动放弃3例(随访发现1个月内均死亡),植物生存1例,重残4例,轻残2例。脑出血微创锥颅术后并发大面积脑梗死与患者的病理基础、占位效应、创伤应激、医源性因素有关。结论脑出血微创锥颅术后并发大面积脑梗死的病因较复杂,临床要以预防为主。临床早期发现术后大面积脑梗死,并及时治疗,可降低致残率和病死率。

Objective To investigate the the etiology and preventive treatment measures of patients after micro-invasive puncture surgery of intracerebra hemorrhage with large area cerebral infarction. Methods Twelve patients of cerebral hemorrhage in basal ganglia were selected from January2010 to October 2014,male 4 cases,female 8 cases,age 50 to 80 years old. The hemorrhage volume of12 patients was 30 ～ 70 ml,and the drainage of minimally invasive cone-cranial hematoma was given,and the cerebral hemorrhage and large-area cerebral infarction were described according to CT images,and the corresponding treatment was given. The risk factors and preventive treatment measures of cerebral hemorrhage complicated with large area infarction after minimally invasive cone cranial operation were discussed. Results Among the 12 patients with cerebral infarction, 2 died, family members automatically abandoned 3 cases（ follow-up found 1 months of death）,plant survival in 1 cases,4 cases of heavy residue,light residue had 2 cases. Large area cerebral infarction after minimally invasive conization of cerebral hemorrhage was related to pathological basis,occupying effect,traumatic stress and iatrogenic factors. Conclusions The causes of large area cerebral infarction after minimally invasive cone craniotomy for cerebral hemorrhage are complicated. The early detection of large-area cerebral infarction after surgery,and timely treatment,can reduce the disability rate and fatality rate.