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作者对210例高血压性脑出血患者采用钻孔引流、锥颅血肿碎吸、小骨窗开颅血肿清除和骨成形瓣开颅血肿清除四种外科方式治疗。术后痊愈和好转151例,死亡59例(28.0%)。根据病情分级,结合CT显示的血肿部位、出血量以及中线结构移位程度,个体化选择手术方式,有助于提高疗效。并分析了影响预后的因素,如出血部位、出血量、血肿破入脑室以及手术时机等;讨论了再出血、颅内积气以及多器官功能衰竭等问题,提出处理措施。并认为,术后进行颅压连续监测,对发现病情变化可以起到重要作用。
The author of 210 cases of hypertensive intracerebral hemorrhage using drilling drainage, cone cranial hematoma suction, small craniotomy hematoma removal and bone flap crescent hematoma removal four surgical treatment. After the operation, 151 cases were cured and improved, 59 cases died (28.0%). According to the grading of the disease, combined with CT showed hematoma site, the amount of bleeding and the midline structure of the degree of shift, individualized selection of surgical methods, help to improve the curative effect. And analyzed the factors that affect the prognosis, such as bleeding site, bleeding volume, hematoma broken into the ventricle and the timing of surgery; discussed the rebleeding, intracranial gas and multiple organ failure and other issues, propose treatment measures. And that postoperative continuous monitoring of intracranial pressure, to find the condition changes can play an important role.