基底节区脑出血手术治疗后二次手术23例分析

目的分析基底节区脑出血二次手术的原因,探讨预防措施和手术注意事项,提高第一次手术效果。方法分析我科近10年来基底节区脑出血患者经二次手术的患者原因及手术方式,总结经验、教训。结果本组23例二次手术原因为:19例原区域再出血,其中3例伴脑室梗阻,4例单纯脑室系统梗阻。二次手术后16例获救,7例死亡。结论基底节区脑出血二次手术主要原因是再出血,与第一次手术中止血不彻底以及术后血压不稳再出血有关;另一原因是脑室梗阻,与第一次手术前血肿已破入脑室及术中、术后血液流入脑室系统有关。

Analysis on the Secondary Surgery of 23 Cases with the Cerebral Basilar Hemorrhage

Objective To improve the operation effect of the cerebral basilar hemorrhage.We analyze the reasons of the recurrent hematoma after first operation to discuss the preventive methods and keys in operation.Methods 23 cases which had suffered secondary operation in recent 10 years sum up to get some experiences.Results the reasons of the 23 cases which had suffered secondary operation were listed as follows:19 cases had suffered from recurrent hematoma in first operational area including 3 cases which accompanied ventricular obstruction and 4 cases had suffered from primary hemorrhagic cerebral ventricular obstruction.After the secondary operation,16 cases were saved and 7 cases were dead.Conclusion The main reasons of secondary operation in basilar area are recurrent hematoma which is related to uncovered hemostasis in first operation and unstable blood pressure after operation.Another reason is primary hemorrhagic cerebral ventricular obstruction(hydrocephalus) which is related to breaking hematoma in ventricle before first operation and diffusion the blood in ventricle during and after operation.