双侧基底节区高血压脑出血治疗的探讨.docVIP

双侧基底节区高血压脑出血治疗的探讨 来源：广东省医药卫生信息网?点击数： 159?更新时间：2008-6-30?文章录入：yjhan ???? 【摘要】? 目的 探讨双侧基底节区高血压脑出血的预后及其个体化治疗方案。方法 分析总结2001年10月至2005年12月收治的9例双侧基底节区高血压脑出血病例的临床资料。结果 9例入院时脑出血意识分级均为四级，哥拉斯格昏迷指数（GCS）评分9分以下；术后日常生活能力（ADL）分级法评定：Ⅲ级（生活部分自理）3例，Ⅳ级（卧床但有意识）2例，Ⅴ级（植物生存）2例；术后2个月死于再出血1例，另1例术后3个月自动出院。结论 术前根据血肿部位和大小、患者神经功能缺失程度以及治疗方式和手术径路对术后神经功能恢复的影响来制定个体化的治疗方案，以尽可能地保全患者尚未缺失的神经功能作为选择治疗的主要考虑并对预后有重要的意义。 【关键词】? 多灶性脑出血 基底节 高血压 ??? The Efficacy of Individual Management in the Treatment of Hypertensive Intracerebral Hemorrhage in Bilateral Basal Ganglia Region. LU Gang, WANG Wei-yu, ZHU Biao, et al. Department of Neurosurgery, Zhejiang Provincial Renmin Hospital. Zhejiang 310014, China ??? ［Abstract］ Objective To explore the individual management and its efficacy in the treatment of hypertensive intracerebral hemorrhage in bilateral basal ganglia region. Methods The clinical data of 9 patients with hypertensive intracerebral hemorrhage in bilateral basal ganglia region were collected and underwent study. Results Consciousness grading scale for intracerebral hemorrhage was grade 4 and the Glascow coma scale was below 9 in all 9 cases at the administration. Grading scale for ability of daily life (ADL) postoperatively was grade Ⅲ in 3 patients, grade Ⅳ in two and grade Ⅴ in the other 2 cases. One patient died of rebleeding 2 months later and another case ceased hospitalization 3 months later after operation. Conclusion It is the most important objective to preservation of residual neurological function individually based on their hemorrhage size and location, neurological deficiency, efficacy of therapeutic methods and surgical approaches and it may improve their prognosis. ??? ［Key words］ Multi_focus intracerebral hemorrhage; Basal ganglia region; Hypertensive blood pressure ??? 双侧基底节区的高血压脑出血临床上较少见，目前也无常规治疗经验和规范可供鉴借。本文对2001年10月至2005年12月收治的9例双侧基底节区高血压脑出血病例的临床资料及治疗结果进行了随访，探讨双侧基底节区高血压脑出血的个体化治疗方案及其预后。 ??? 1? 临床资料 ??? 1.1? 一般资料：本组9例患者中男3例，女6例；年龄43～68岁，平均年龄52.7±14.0岁；患者均有明确的原发性高血压病史，且已接受降压药物治疗多年，但多数