高血压脑出血术后再出血的探讨

目的：探讨高血压脑出血手术后再出血的原因及防治措施。方法：对65例高血压脑出血开颅血肿清除术后再出血的病例进行同顾性临床资料分析。结果：高血压脑出血术后再出血发生率15．8％（65／412），死亡率49．2％（32／65）：再出血的主要临床表现为意识障碍加深、瞳孔变化及骨窗张力增高（去骨瓣患者）。手术后血压仍持续增高且波动幅度大；66．2％（43／65）再出血发生在手术后24h内。结论：再出血的主要原因为手术中止血不彻底以及手术后血压高且波动幅度大。术中妥善的止血和术后保持血压平稳是避免和减少再出血的关键因素。

Clinical analysis on resurgence hemorrhage of postoperative hypertensive intracerebral hemorrhage

Objective;To expore the cause of resurgence hemorrhage of postoperative Hypertensive intracerebral hemorrhage and surgical management in clinic.Methods;To summarize 65 cases of resurgence hemorrhage of postoperative Hypertensive intracerebral hemorrhage.Results;Incidence of resurgence hemorrhage in postoperation was 15.8%,mortality of the cases 49.2%.Main clinical manifestation resurgence hemorrhage was that the disturbance of consciousness was enhanced,pupils were altered and the blood pressure could not be controlled stably.66.2% cases with resurgence hemorrhage occurred in 24 hours.Conclusion;Main cause of resurgence hemorrhage was not stanch bleeding entirely during operation and blood pressure of the patients was unstable.After operation,key factor of preventing the resurgence hemorrhage is controlling bleeding properly during operation and keeping blood pressure in stable condition in postoperation.