中青年脑溢血手术疗效剖析.docVIP

中青年脑溢血手术疗效剖析 　　摘要：目的：探讨中青年脑溢血手术后临床效果。 　　方法：回顾性分析32例中青年高血压脑出血患者的临床资料，根据患者的意识状态，瞳孔变化，出血时间，出血部位，血肿量等，采用小骨窗血肿清除术，大骨窗血肿清除并去骨瓣减压术，及侧脑室外引流术手术疗效进行探讨。 　　结果：选择小骨窗血肿清除术24例，术后日常生活能力（ADL）评级Ⅰ级12例，Ⅱ级7例，Ⅲ级3例，Ⅳ级1例，Ⅴ级1例。大骨窗血肿清除并去骨瓣减压术6例，术后ADL评级Ⅰ级3例，Ⅱ级0例，Ⅲ级1例，Ⅳ级1例，Ⅴ级0例，死亡1例。侧脑室外引流术2例，ADL评级Ⅰ级0例，Ⅱ级0例，Ⅲ级1例，Ⅳ级0例，Ⅴ级0例，死亡1例。 　　结论：中青年脑溢血手术疗效优于老年脑溢血，术后恢复较好，应争取在发病后尽早手术清除血肿，减少血肿继发脑损害，提高病员生存质量。 　　关键词：中青年 高血压 脑出血 手术疗效 　　Doi：10.3969/j.issn.1671-8801.2014.06.027 　　Abstract：Objective： To investigate the clinical effects of youth and middle-age with cerebral hemorrbage after surgicaltreatment. 　　Methods：Retrospective analysis of 32 cases clinical data in young and middle-aged patients with hypertensive cerebral hemorrhage，according to the patients state of consciousness，pupillary changes，bleeding time，bleeding site，hematoma volume，etc.，to explore the effectofsurgicaltreatment with using a small bone window hematoma，a large bone window hematoma and boneless decompression valve，and lateral lateral ventricle drainage operation. 　　Result： Choose small bone window hematoma 24 cases of postoperative activities of daily living （ADL） rating grade Ⅰ 12 cases，Ⅱ grade 7 cases，Ⅲ grade 3 cases，Ⅳ grade 1 case，Ⅴ grade 1 case.Large bone window hematoma and decompressive craniectomy 6 cases，postoperative ADL rating grade Ⅰ 3 cases，grade Ⅱ 0 cases，Ⅲ grade 1 cases，Ⅳ grade 0 cases，Ⅴ grade 1 case，1 cases died.Two cases of lateral external drainage，ADL rating grade Ⅰ 0 cases，grade Ⅱ 0 cases，grade Ⅲ 1 cases，Ⅳ grade 0 cases，Ⅴ grade 0 cases，1 cases died. 　　Conclusion：Young and middle-age with cerebral hemorrhage surgical curative effect is superior to the elderly cerebral hemorrhage，postoperative recovery is good，we should strive for surgicaltreatment as soon as possible after the onset of surgery to remove the hematoma，reduce the secondary brain damage after hematoma，improve the quality of patient’s life. 　　Keywords：Youth and middle-age Hypertensive cerebral hemorrbage The effect of surgical treatment 　　【中图分类号】