高血压脑干出血显微手术治疗进展

Advancements in microsurgical treatment of Hypertensive Brainstem Hemorrhage

高血压脑干出血(HBSH)是所有脑血管病中预后最差和病死率最高的疾病,目前国内外以内科保守治疗为主。随着临床对脑干解剖及功能区认识的不断增长,以及神经影像、显微外科技术、神经导航、神经内镜、术中监测和神经康复等领域新技术和设备的进步,这为开展脑干出血“微创”手术治疗提供了选择和保证。手术清除血肿可降低血肿的占位效应,缓解对脑干的压迫,减少吸收期血液产物分解引起的细胞毒性效应。该文就显微血肿清除术在HBSH中的应用进展展开综述。

Hypertensive brainstem hemorrhage(HBSH)has the poorest prognosis and highest mortality rate among all cerebrovascular diseases,and current treatments mainly focus on conservative medical management both domestically and internationally.However,with the continuous advancement in knowledge of brainstem anatomy and functional areas,as well as the progress in new technologies and equipment in the fields of neuroimaging,microsurgical techniques,neuro-navigation,neuroendoscopy,intraoperative monitoring,and neurorehabilitation,there are now options and guarantees for the development of"minimally invasive"surgical treatments for brainstem hemorrhage.Surgical evacuation of the hematoma can reduce its mass effect,alleviate compression on the brainstem,and mitigate the cytotoxic effects caused by the breakdown of blood products during the absorption phase.This article provides an overview of the application and progress of microhematoma evacuation surgery in HBSH.