摘要
目的探讨皮层静脉梗死性脑出血的病因及治疗。方法回顾性分析新疆医科大学第一附属医院2014年7月-2016年7月手术的27例皮层静脉梗死性脑出血的临床资料。结果 23例行开颅手术清除血肿及梗死脑组织并复位骨瓣;1例行小骨窗手术仅清除血肿,术区再出血,再次行开颅手术清除血肿及梗死脑组织并复位骨瓣;3例仅行去骨瓣减压术,术后出血增加,1例再次开颅手术清除血肿及梗死脑组织,另2例放弃治疗死亡;术后9例治愈,15例转康复治疗,3例死亡。24例随访2月至2年,3例因肺部感染死亡,1例因心梗死亡,余20例均未再次因脑出血入院。结论皮层静脉及静脉窦血栓形成是皮层静脉梗死性脑出血的主要病因,开颅手术清除血肿及梗死脑组织是有效治疗方法,可复位骨瓣、降低术后出血机率,提高生存率并改善预后。
Objective To investigate the Etiology and Treatment method of Cerebral Cortical Vein Infarction Hemorrhage.Methods The clinical data of 27 cases with Cerebral Cortical Vein Infarction Hemorrhage, who were operated at Department of Neurosurgery in the first affiliated hospital of Xinjiang medical university from July 2014 to July 2016, were retrospectively analyzed;Results 23 cases underwent hematoma evacuation and infarcted brain tissue removal through craniotomy combined with bone flap resetting; 1 case underwent small bone window craniotomy, then received a second operation because of postoperative rebleeding; 3 cases just underwent decompressive craniectomy at the early stage, then cerebral hemorrhage increased subsequently after operation. 1 cases received the second operation to remove the hemotoma and infarctus brain tissue. 2 cases refused reoperation and died; After operation, 9 cases were cured, 15 cases were relieved symptom, and 3 cases were died. 24 cases were followed up from 2 months to 2 years, 3 cases died of pulmonary infection. 1 cases died of myocardial infarction. other 20 cases were not hospitalized again; Conclusion Cortical vein or Sinuses Thrombosis is the main reason of Cerebral Cortical Vein Infarction Hemorrhage. Hematoma evacuation and infarcted brain tissue removal via craniotomy combined with bone flap resetting is an useful surgical treatment, it can significantly reduce the vascular rebleeding rate, increase survival rate, preserve the integrity of the cranial cavity and improve the prognosis.
作者
付强
陈培培
李绍山
廖佐明
王增亮
刘波
周庆九
FU Qiang;CHEN Peipei;LI Shaoshan;LIAO Zuoming;WANG Zengliang;LIU Bo;ZHOU Qingjiu(The first affiliated hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)
出处
《新疆医学》
2018年第7期745-748,共4页
Xinjiang Medical Journal
基金
新疆医科大学第一附属医院院内科学自然基金-青年基金(2015ZRQN15)
关键词
皮层静脉梗死
脑出血
病因
治疗
Cortical Vein Thrombosis
Cerebral Hemorrhage
Etiology
Treatment
