【作者】 陈永顺； 甘鸿川； 曹楚南； 明悦； 潘政； 张欣； 王新军； 单峤； 寿纪新； 刘窗溪； 李玉明； 杨华； 赵建华； 钱希颖； 柏顺民；

【Author】 Chen yongshun,Gan hongchuan,Cao chunan,et al.Neurosurgical Department of Guiyang Brain Hospital,Guiyang 550005,China;Wang xinjun,shan jiao,Shou jixin,Neurosurgical Department of Zhenzhou Railway Central Hospital,Zhenzhou,China Liu chuangxi,Li yuming,Yang hua,Neurosurgical Department of Guiyang Medical College Affiliated Hospital,Guiyang 550002,China;Zhao jianhua, Qian xiying,Boshunmin,Neurosurgical Department of Yunnan No.1 People Hospital, Kunming,China

【机构】 中医一附院神经外科； 贵阳脑科医院神经外科； 郑州铁路局中心医院； 贵阳医学院附属医院； 云南省第一人民医院；

【摘要】 目的探讨早期采用大骨瓣开颅、显微神经外科手术治疗自发性脑出血并脑室铸型的可行性、方法及疗效。方法将本组病例按出血并铸型脑室的多少而分为4型,针对不同的分型设计并采用相应的术式,早期或超早期大骨瓣开颅,镜下一次性清除全部或大部分脑内及脑室内血肿铸型,置管引流,扩大硬膜成型缝合,弃骨瓣减压。结果本组198例,治愈165例,死亡33例,存活率为83.33%,死亡率为16.67%。治愈者出院时生存质量按日常生活能力(ADL)分级评定。ADL分级Ⅰ级6例,Ⅱ级77例,Ⅲ级67例,Ⅳ级15例。结论该方法治疗自发性脑出血并脑室铸型对降低死亡率和提高生存率及生存质量有实际意义。更多还原

【Abstract】 Objective To explore the safety and effectiveness of the microsurgical treatment of spontaneous intracerebral hemorrhage with intrventricular hematoma. Methods According to the intrventricular which effected by the hemorrhage,we decided their type(Ⅰ,Ⅱ,Ⅲ,Ⅳ) and adopted corresponding approach,early or ultra-early open craniotomy to evacuate total/subtotal hemorrhage under microscope,A catheter was placed the cavity or the intrventricular to drainage,reconstructed subdural space by amplifier sewing dura,abandoning bone flap to decompress. Results one hundred of ninety-eight patients were treated microsurgically via craniotomy,one hundred of sixty-five patients had been cured;thirty-three patients had died;survival ratio was 83.33%;mortality was 16.67%.acoording to the ADL outcome score,six patients were GradeⅠ;seventy-seven were GradeⅡ;sixty-seven were GradeⅢ;fifteen were GradeⅣ. Conclusions the microsurgery is significant way to treat spontaneous intracerebral hemorrhage with intrventricular hematoma.,which can decrease mortality and increase survival ratio;at the same time,which can improve survival quality.更多还原