高血压脑出血并发脑疝形成的手术治疗.pdfVIP

■论著一 高血压脑出血并发脑疝形成的手术治疗 熊小兵昊许清-g晓兵龚葵邻勇 (江西省宜丰县人民医院神经外科，宜丰336300) 摘要目的：探讨高血压脑出血并发脑疝形成手术治疗的适应症及治疗疗效。方法：手术治疗36例，根据CT定位，幕上血肿 骨瓣开颅、幕下血肿骨窗开颅．主要以脑室出血者单纯行脑室穿刺引流术。从死亡病例的出血部位及死亡原因分析中，寻找 选择手术适应证及提高疗效方法。结果：存活23例，根据COS评分定残标准，良好6例，中残9例，重残7例-植物生存1例， 死亡13例，死亡率35％。结论：提高手术治疗高血压脑出血并发脑疝形成成功率的关键在于严格选择适应证，尽早清除血 肿，充分碱压，加强围手术期的处理。 关键词高血压脑出血脑疝手术治疗 ：2 7 Treatmentof Cerebral with Surgical HypertensiveHemorrhageComplicated BrainHernia Xiao of Hos— Wu Neurosurgery，ThePeople’s XiongXiaobingXuqingXiaobing，et“．(Department of 336300) pitalYifengCounty，Yifeng theselectionof treatmentof with cerebral brain Abstract surgical patientshypertensivehemorrhage Objective：Tostudy received to withhemiaandhowtoincreasetherapeuticefficacy．Methods：Thirty—ixpatients operativetherapy，according or window CTscanIocalization，intracerebralhematomawasremovedwithskullflap skull stan— and the siteandthecauseofthedeaths，tostudy hemalomawithventriculor dramageAnalyzingbleeding along puncture ofselection for andmethodsof ofthe patients dard patientssurgery improvementtherapeutic were were ormilddisable— survivedandthineenDatlentsdied．The effectsevaluatedCOS，theregoodrecovery therapeutic by in9 disablementin7 inIcaseTh