摘要
目的总结高血压脑出血患者术后再出血及二次手术的临床经验。方法回顾性分析12例高血压脑出血患者术后再出血及二次手术的临床资料,其中基底节出血9例、大脑皮层出血2例、小脑出血1例,首次手术方式为小骨窗开颅血肿清除7例、开颅血肿清除术及大骨瓣减压4例、血肿穿刺引流术1例。结果CT复查发现8例再出血<24 h,2例24~48 h,2例48 h~5 d。二次手术方式为开颅血肿清除术及大骨瓣减压10例、小骨窗血肿清除术2例。出院时神志清楚不伴肢体功能障碍1例,清醒伴偏瘫2例,嗜睡伴偏瘫2例,浅昏迷伴偏瘫2例,死亡或放弃治疗5例。结论术中彻底止血和术后控制血压是避免高血压脑出血患者术后再出血及二次手术的关键。
Objective To summarize the clinical experience of rebleeding and second surgery following hypertensive cerebral hemorrhage(HCH).Methods Clinical data of 12 HCH patients with rebleeding and second surgery were retrospectively analyzed.The hematomas occurred in basal ganglia region in 9 cases,cerebral cortex in 2 and cerebellum in 1.The first operation approaches included small bone-window craniotomy in 7 cases,craniotomic hematoma removal and large bone flap decompression in 4,and hematoma puncture drainage in 1.Results CT reexamination showed rebleeding occurred during 24 h in 8 cases,24-48 h in 2,and 48 h-5 d in 2.The second operation methods were craniotomic hematoma removal and large bone flap decompression in 10 cases and small bone-window craniotomy in 2.At discharge,1 patient was conscious without limb dysfunction,2 awake with hemiplegia,2 lethargic with hemiplegia,2 mild coma with hemiplegia,and 5 dead or abandoned.Conclusion Intraoperative complete hemostasis and postoperative blood pressure control are crucial to avoiding rebleeding in HCH patients.
作者
刘豪然
陈兵
龙霄翱
余庆旺
陈启文
吴成坤
廖壮槟
岑学程
黄拔齐
吴伟川
莫伟
LIU Hao-ran;CHEN Bing;LONG Xiao-ao;YU Qing-wang;CHEN Qi-wen;WU Cheng-kun;LIAO Zhuang-bin;CEN Xue-cheng;HUANG Ba-qi;WU Wei-chuan;MO Wei(Department of Neurosurgery,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)
出处
《广东医科大学学报》
2022年第2期205-208,共4页
Journal of Guangdong Medical University
关键词
高血压脑出血
再出血
二次手术
hypertensive cerebral hemorrhage
rebleeding
second surgery
