| 岳景齐,钟志坚,孙海鹰,田登攀,蒋开元,王建荣,贺小平,刘艳萍.内镜辅助下血肿清除加去骨瓣减压术治疗重症高血压基底节脑出血.[J].中南医学科学杂志.,2014,42(6):582-584. |
| 内镜辅助下血肿清除加去骨瓣减压术治疗重症高血压基底节脑出血 |
| Hematoma Evacuation and Decompressive Hemicraniectomy forSevere HIH in the Basal Ganglia Through Endoscopic Assisted |
| 投稿时间：2014-08-25 |
| DOI： |
| 中文关键词: 高血压脑出血 基底节区 内镜辅助 血肿清除术 去骨瓣减压术 |
| 英文关键词:hypertensive intracerebral hemorrhage basal ganglia endoscopic assisted hematoma evacuation decompressive hemicraniectomy |
| 基金项目:湖南省科技厅资助项目(2012SK3037). |
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| 中文摘要: |
| 目的探讨内镜辅助下重症高血压基底节脑出血患者的的手术方法和治疗效果。方法回顾性连续收集22例患者的临床资料，均采用血肿同侧扩大翼点入路，经显微手术血肿部分清除后，辅以神经内镜清除残留血肿、彻底止血，再施行去骨瓣减压。术后予以系统化外科治疗和康复治疗，复查头部CT，计算生存率与死亡率，随访并进行术后3个月GOS评分。结果术后24 h、72 h、第7天复查头部CT结果显示，血肿完全清除11例，血肿大部分清除8例，血肿部分清除3例，均无再发血肿。经积极治疗后，生存20例(90.9%),死亡2例(9.1%)。术后3个月GOS预后评分中度残疾12例，严重残疾7例，持续植物人状态1例，死亡2例。结论内镜辅助下血肿清除加去骨瓣减压能有效地清除脑内血肿，提高生存率、降低死亡率，是外科治疗重症高血压脑出血的有效方法。 |
| 英文摘要: |
| ObjectiveTo discuss surgery method and treatment effect for severe hypertensive intracerebral hemorrhage(HIH) in basal ganglia microneurosurgery through endoscopic assisted.Methods22 cases were continuously collected,removing hematoma via the ipsilateral hematoma extended pterional approach in microsurgery,supplemented by endoscopic removal of residual hematoma,thorough hemostasis,then underwent decompressive hemicraniectomy.The patients Post- operation were treated by systematic surgical method and rehabilitation therapy,checking the head CT,calculating survival rate and mortality rate,following up,evaluating GOS score when 3 months after surgery.ResultsThe results of head CT showed,11 cases of hematoma were completely removed,8 mostly removed,3 partially removed,while 24 h,72 h,7 d post-operation,there was no recurrence of hematoma.After active treatment,20 cases(90.9%) were survived,2 cases(9.1%) were dead.Postoperative follow-up of 3 months,according to Glasgow Outcome Scale,12 cases were of medium disability,7 severe disability,1 persistent vegetative station，2 dead.ConclusionsEndoscope assisted hematoma evacuation and decompressive hemicraniectomy microneurosurgery can remove the hematoma effectively,improve the survival rate,reduce the mortality rate,which is an effective method for surgical treatment of severe hypertensive cerebral hemorrhage. |
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