高血压小脑出血的手术治疗

目的探讨高血压小脑出血的手术治疗方法和疗效。方法对29例采取手术方式治疗的高血压小脑出血患者病例资料进行回顾性分析。结果 25例患者行超早期小骨窗开颅显微清除血肿术;5例行血肿清除并后颅窝减压、脑室外引流术;急诊钻孔血肿清除、脑室外引流术;2例单纯脑室引流术。术后再出血2例,死亡3例。术后6个月,28例生存者预后按ADL分级：Ⅰ级5例,Ⅱ级7例,Ⅲ级7例,Ⅳ级6例,Ⅴ级3例。结论根据高血压小脑出血的血肿部位,脑积水情况和临床症状,采取及时有效的手术方式治疗,有助于清除血肿、改善预后。

Surgical Treatments for Patients with Hypertensive Intracranial Hemorrhage of Cerebellum

Objective To explore the surgery methods,and evaluate the therapeutic effect and prognosis of patients with hypertensive intracranial hemorrhage of cerebellum.M ethods From January 2008 to December 2011,29 patients with hypertensive intracranial hemorrhage of cerebellum were treated by different surgical methods,and the clinical data of these patients were analyzed retrospectively.Results Of total 29 patients,the treatment of ultra-early microsurgery with microsurgery with mini-craniotomy was taken in 14 cases,the treatment of microsurgery with decompressive craniectomy and paraventriculostomy was taken in 8 cases,the emergency treatment of drilling skull,draingage and paraventriculostomy was taken in 4 cases,the treatment of paraventriculostomy alone was taken in 3 cases.One patients rebleeded and 3 patients died after surgery.The 22 follow-up patients were evaluated by activities of daily living（ADL） 6 months after surgery,gradeⅠwas found in 4 cases,Ⅱ in 8 cases,Ⅲ in 4 cases,Ⅳ in 3 cases,Ⅴ in 3 cases.Conclusion Based on the situation of the hematoma,hydrocephalus and clinical features,it＇s an effective treatment to remove the hematoma,rescue obstructive hydrocephalus and improve prognosis by means of employing different surgical operations for patients with hypertensive intracranial hemorrhage of cerebellum.