高血压脑出血手术治疗研究进展

Research progress in surgical treatment of hypertensive intracerebral hemorrhage

高血压是导致脑出血最常见的因素之一,同时高血压患者伴有脑内小动脉病变,最常见的是合并小动脉硬化,多种因素的影响会导致血压骤升,最终造成动脉破裂引起出血,也被称为高血压性脑出血。一次性出血基本在30 min内停止,致命性出血会直接导致患者死亡。最近几年,通过CT动态观察研究得知:>80%的脑出血患者在发病的6 h内还存在血肿增大的现象,而>15%的人在6~24 h内血肿增大,只有极少数的患者在2 d后还存在增大现象。另外,高血压性脑出血,在发病后继续出血的概率基本>50%,1 d内出血概率为60%,同时还发现血压和年龄不是导致继续出血的原因,但是血肿不规则或出血量较多,则会导致继续出血。因此为减少高血压脑出血危害性,强化手术治疗效益,本文主要针对高血压脑出血手术治疗的研究进展进行综述,以期为高血压脑出血的临床治疗提供帮助。

Hypertension is one of the most common factors leading to intracerebral hemorrhage.At the same time,patients with hypertension is accompanied by small arterial lesions in the brain.The most common type of hypertension is combined with arteriosclerosis,and the influence of multiple factors can lead to a sudden increase in blood pressure,ultimately causing arterial rupture and bleeding,also known as hypertensive intracerebral hemorrhage.A one-time bleeding,it will basically stop within 30 minutes,and the fatal bleeding can directly lead to the death of the patient.In recent years,through dynamic CT observation research,it has been shown that more than 80% of patients with intracerebral hemorrhage still have an increase in hematoma within 6 hours of onset,while more than 15% of patients have an increase in hematoma within 6-24 hours,and only a very small number of patients still have an increase in hematoma after 2 days.In addition,the probability of continued bleeding after onset of hypertensive intracerebral hemorrhage is basically more than 50%,and the probability of bleeding within 1 day is 60%.At same time,it is also found that blood pressure and age are not the reasons for continued bleeding,but irregular hematoma or large bleeding volume can lead to continued bleeding.Therefore,in order to reduce the harm of hypertensive intracerebral hemorrhage and enhance the effectiveness of surgical treatment,this article mainly reviews the research progress of surgical treatment for hypertensive intracerebral hemorrhage,in order to provide assistance for the clinical treatment of hypertensive intracerebral hemorrhage.