自发性脑干出血161例的治疗及预后分析.docVIP

自发性脑干出血161例的治疗及预后分析 　　[摘要] 目的 总结、分析脑干出血的治疗及预后。 方法 整群选取并回顾性分析该院2000年1月―2014年5月收治的161例脑干出血病人，全部病人分为轻型、中型、重型、特重型4型；昏迷病人出现呼吸改变为分呼吸机辅助通气组及非呼吸机辅助通气组。分析各型及各组的治疗及预后。 结果 各型平均出血量分别为：（1.58±1.05）mL、（3.05±1.31）mL、（5.92±2.071）mL、（8.34±2.04）mL，不同分型组间死亡率P0.05，预后与出血量相关。呼吸机辅助通气组与非呼吸机辅助通气组死亡率P0.05。结论 脑干出血的治疗以内科保守治疗为主，出血量及出血量增多是影响预后主要因素，GCS评分可有效评估预后，并对针对性治疗有指导意义。 　　[关键词] 脑干出血； GCS评分；治疗；预后 　　[中图分类号] R722.15+1 [文献标识码] A [文章编号] 1674-0742（2016）05（c）-0116-03 　　[Abstract] Objective To summarize and analyze the treatment and prognosis of hemorrhage of brain stem. Methods 161 cases of patients with hemorrhage of brain stem treated in our hospital from January 2000 to May 2014 were retrospectively analyzed and divided into mild type， moderate type， severe type and extra-severe type， and the coma patients with respiration changes were divided into the ventilator aid respiration group and the non-ventilator aid respiration group， and the treatment and prognosis of each type and each group were analyzed. Results The average blood loss of each type was respectively （1.58±1.05） mL， （3.05±1.31） mL， （5.92±2.071） mL and （8.34±2.04） mL， and the difference in the death rate between groups of different types had statistical significance， P0.05， the prognosis was correlated with the blood loss， and the difference in the death rate between the ventilator aid respiration group and the non-ventilator aid respiration group had statistical significance， P0.05. Conclusion The treatment for hemorrhage of brain stem was mainly conservative medical treatment， the blood loss and blood loss increase were the main influencing factors of prognosis， and GCS score can effectively evaluate prognosis， and it is of guidance significance to the targeted treatment. 　　[Key words] Hemorrhage of brain stem； GCS score； Treatment； Prognosis 　　脑干出血发病率相对较低，约占所有脑出血的7%～10%，是神经内外科的危急病，起病急、进展快，病情重、死亡率高，存活者多遗留严重的后遗症，治疗上需对患者进行全面评估，制定个体化治疗方案，以期获得满意效果，改善病人预后。该文对该院2000年1月一2014年5月神经外科、神经内科及ICU科收治的自发性脑干出血161例病人临床资料进行回顾性分析，总结治疗经验，分析预后