高血压脑出血破入脑室手术时机和手术方式对病情转归的影响.pdfVIP

第32卷 黑 龙 江 医 学 VD1．32．No．7 522 2008年第7期 HEI I NG J NG MEDICAL JOURNAL Ju1．2008 高血压脑出血破入脑室手术时机和手术方式对病情转归的影响 毛 铁，吴春菊 (黑龙江省医院，黑龙江哈尔滨 150036) 摘要：目的 探讨高血压脑出血破入脑室不同手术时机和手术方式对病情转归的影响。方法 采用回 顾性分析的方法，选择了185例不同手术时机(7 h、7 h～48 h，48 h)，3种治疗手段即常规开颅血肿清除 术、脑室外引流辅助尿激酶灌注结合腰穿脑脊液置换治疗、单纯腰椎穿刺治疗的高血压脑出血破入脑室患 者，进行死亡率、预后情况比较分析O结果 病情转归(AD 和ADI4)7 h者，较7 h～48 h、7 h～48 h较 48 h者良好(PO．05)，有显著差异；3种不同治疗手段脑室外引流组死亡率最低，开颅血肿清除术组次 之，单纯腰椎穿刺治疗组最高，3者相比P0．05。结论 高血压脑出血手术时机超早期好于早期，早期又 好于延期，治疗手段脑室外引流好于常规开颅血肿清除术、常规开颅血肿清除术好于单纯腰椎穿刺治疗。 关键词：高血压脑出血；脑室；脑室外引流；尿激酶；手术时机 学科分类代码：320．2725 中图分类号：R651．12 文献标识码：B 文章编号：1004—5775(2008)07—0522—02 Effect on Prognosis of Operative Time and Method for Leakage into Ventricle for Hypertension Cerebral Hemorrhage Patient MAO Tie，WU Chun—ju (The Provincial Hospital ofHeilongjiang，Harbin 150001) Abstract：Objective To discuss the effect on prognosis of operative time and method for leakage into ventricle f0r hy— pertension cerebral hemorrhage．Methods 185 cases of such patient weI℃analyzed in varied operative time(within 7 h，7～48 h and over 48 h)and three different methods(routine relTIOVe of hematoma，extra—ventricle drainage witl1 urokinase perfusion and CSF replacement and single lumbar ptmcture)in mortality and prognosis．Results ADL1 and ADL2 tl1il1 7h were better than those in other two groups witl1 P 0．05． rhe effect of method was better in second group．then first and last witl1 P 0．05．Conclusion e early therapy of such patient might have better effect as well as extra～ventricle drainage and tl1en hematoma remove． Key words：Hypertension cerebral hemorrhage；Ventricle；Extra—·ventricle drainage；Umkinase；Operative time 高血压脑出血根据流行病学调查，脑出血的发病率为 包括术式的选择、手术时机、术后治疗等，需要进一步探讨 50．6～8