高血压脑出血术后再次出血的临床分析

Clinical analysis of rebleeding after operation for Hypertensive intracerebral hemorrhage

目的 探讨高血压脑出血术后再出血的原因,诊治和预防。提高对本病的认识以便及时发现处理。方法本组24例高血压脑出血病人,入院后均行开颅血肿清除术,术后病情无好转,意识障碍加深,复查头部CT证实再出血,都予再次行开颅手术血肿清除手术。结果 恢复良好13例,生活基本能自理4例,生活需要他人照料3例,植物生存2例,死亡2例。结论术中彻底止血、术后血压控制平稳能较有效防止再出血;而术后对病情应严密监测,及时复查CT,尽早发现井手术能改善预后和降低死亡率。

Objective: To improve understanding of rebleeding after operation for hypertensive intracerebral hemorrhage so that it can be diagnosed in the early phase and treated in time, the cause, diagnosis, treatment and prevention of it was analyzed. Methods: 24 cases of hypertensive intracerebral hemorrhage were operated after hospitalization, but disturbance of consciousness of the patients got bad, Rebleeding of the patients was verified by repeated CT and operated again. Results 13 cases convalesce well, 4 cases could take care of himself. 3 cases should be undertook care by others. 2 cases are vegetative patients, and 2 cases died. Conclusion In order to prevent the recurrence of rebleeding after operation for hypertensive intracerebral hemorrhage, we should stop bleeding carefully during operation and control blood pressure smoothly after operation. The patients with operation after hypertensive brain hemorrhage must be monitored rigorously, be diagnosed by repeated CT in the early phase it needed and operated in time, prognosis can be improved and the mortality rate decrease.