高血压脑出血患者的超早期急诊手术与监护

Early emergency operation and intensive care in hypertensive intracerebral hemorrhage

目的 评价高血压脑出血超早期急诊手术和重症监护的救治作用。方法 回顾性分析近 4年来我院进行的 1 0 5例高血压脑出血患者的超早期手术的类型、方法与术后监护。结果 出院时 1 0 5例患者中完全治愈 31例 ,遗留轻度偏瘫及其他轻度后遗症者 2 8例 ,重度残废 34例 ,持续植物状态 5例 ,死亡9例 ;手术后再出血者 4例 ,出血原因与术后血压波动、术中止血不彻底有关。从出血类型分析 ,破入脑室或脑室内出血及小脑出血并梗阻性脑积水者恢复最快 ,基底节区出血多遗留有不同程度的偏瘫 ,在优势半球侧还遗留有不同程度的失语 ,对患者自理能力影响大。结论 超早期急诊手术和术后监护对高血压脑出血的治疗结果起到积极作用 ,尤其是引起脑室系统梗阻的出血患者。

Objective To evaluate the value of early emergency operation and intensive care in hypertensive intracerebral hemorrhage.Methods A retrospective analysis was conducted on 105 cases who underwent early emergency operation and post_perative monitoring.Results 31 of 105 patients recovered,28 had mild sequelae,34 were severely disabled,and 9 died.4 cases had rebleeding after operations because of unstable blood pressure and incomplete hemostasis during emergency operation.Conclusion Early energency operation is valuable for hypertensive hemorrhage,specially for bleeding in ventricles orcerebella with obstructive hydrocephalus.Specialized monitoring in ICU is necessary to prevent rebleeding and complications. [