小脑出血的手术治疗(附35例临床分析)
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摘要
目的探讨外科手术治疗高血压性小脑出血的疗效。方法回顾性分析2007年1月至2013年6月手术治疗的35例高血压性小脑出血患者的临床资料;观察疗效并进行随访。结果术后随访6个月,格拉斯哥预后量表(GOS)评分为良好者19例,中残6例,重残3例,死亡7例。25例良好和中残患者术后均有不同程度的头晕、恶心、共济失调等症状。结论高血压性小脑出血病情重,进展迅速,具有很高的致残率和死亡率;及早诊断和手术,是提高治疗效果的关键。
Objective To evaluate the curative effects of the surgical treatment for hypertensive cerebellar hemorrhage. Methods The clinical data of 35 patients with hypertensive cerebellar hemorrhage underwent operation from January 2007 to June 2013 were analyzed retrospectively. Results All patients were followed up for six months after operations. GOS score showed that there were 19 patents in grade Ⅴ,6 in grade Ⅳ,3 in grade Ⅲ and 7 in gradeⅠ. The majority symptoms of patients were dizziness,nausea,ataxia. Conclusions Hypertensive cerebellar hemorrhage has the rapid progression of disease,with high morbidity and mortality. Early diagnosis and early operation are the keypoints to improve the prognosis.
Objective To evaluate the curative effects of the surgical treatment for hypertensive cerebellar hemorrhage. Methods The clinical data of 35 patients with hypertensive cerebellar hemorrhage underwent operation from January 2007 to June 2013 were analyzed retrospectively. Results All patients were followed up for six months after operations. GOS score showed that there were 19 patents in grade Ⅴ,6 in grade Ⅳ,3 in grade Ⅲ and 7 in gradeⅠ. The majority symptoms of patients were dizziness,nausea,ataxia. Conclusions Hypertensive cerebellar hemorrhage has the rapid progression of disease,with high morbidity and mortality. Early diagnosis and early operation are the keypoints to improve the prognosis.
引文
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[11]张占英,张方成.钻孔抽吸引流治疗高血压脑出血破入脑室的体会(附23例报告)[J].中国临床神经外科杂志,2011,16:443.
[12]刘轶刚,郑鲁,姚智强.硬脑膜扩大修补在高血压脑出血的临床应用[J].四川解剖学杂志,2011,19:35.
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[14]蒋金泉,郭建杰,何金定,等.超早期立体定向手术治疗高血压小脑出血[J].临床神经外科杂志,2015,12:101.
[15]张逵,张渊,范润金,等.高血压性小脑出血的手术治疗[J].国际神经病学神经外科学杂志,2014,41:510.
[2]Steiner T,Al-Shahi Salman R,Beer R,et al.European stroke organisation(ESO)guidelines for the management of spontaneous intracerebral hemorrhage[J].Int J Stroke,2014,9:840.
[3]任光辉,李晓良.高血压性小脑出血破入脑室41例的手术分析[J].中国临床神经外科杂志,2012,17:118.
[4]吴德权,邵君飞,张晓路,等.开颅治疗重型脑室铸型血肿疗效评估[J].中华神经外科杂志,2014,30:372.
[5]王代旭,陈金华,金保山,等.高血压性小脑出血的手术治疗[J].中国临床神经外科杂志,2012,17:438.
[6]于广久,米山,郑玲莉,等.Ommaya囊辅助侧脑室穿刺引流术在高血压小脑出血治疗中的应用[J].临床神经外科杂志,2015,12:68.
[7]Du B,Wang J,Zhong XL,et al.Single versus bilateral external ventricular drainage for intraventricular fibrinolysis using urokinase in severe ventricular haemorrhage[J].Brain Injury,2014,28:1413.
[8]刘勇,张俊义,王建军.锥颅留置Codman颅内压脑室导管治疗高血压脑出血的疗效观察[J].中国医药指南,2015,11:47.
[9]Jens W,Neugebauer H,Zweckberger K,et al.Primary cerebellar haemorrhage:Comlications,treatment and outcome[J].Clin Neurol Neurosurg,2013,115:863.
[10]蔡可胜,袁运尚.血肿穿刺加脑室外引流治疗高血压脑出血89例临床分析[J].临床神经外科杂志,2014,11:145.
[11]张占英,张方成.钻孔抽吸引流治疗高血压脑出血破入脑室的体会(附23例报告)[J].中国临床神经外科杂志,2011,16:443.
[12]刘轶刚,郑鲁,姚智强.硬脑膜扩大修补在高血压脑出血的临床应用[J].四川解剖学杂志,2011,19:35.
[13]蔡可胜,袁运尚.腰大池持续外引流术在开颅术后的临床应用[J].中国临床神经外科杂志,2014,19:446.
[14]蒋金泉,郭建杰,何金定,等.超早期立体定向手术治疗高血压小脑出血[J].临床神经外科杂志,2015,12:101.
[15]张逵,张渊,范润金,等.高血压性小脑出血的手术治疗[J].国际神经病学神经外科学杂志,2014,41:510.