高血压脑出血术后再出血的原因及防治

目的探讨高血压脑出血术后再出血原因及防治。方法对15例高血压脑出血血肿清除术后再出血的病例进行回顾性临床资料分析。结果高血压脑出血术后再出血发生率23.1%(15/65),病死率60.0%(9/15);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。结论术中止血不彻底、术后血压明显的波动是造成高血压脑出血术后再出血的主要原因,合理选择手术时机、术中妥善止血、术后积极控制血压可减少高血压脑出血术后再出血发生率。

The Cause and Prevention of Postoperative Rehaemorrhagia of Hypertensive Intracerebral Hemorrhage

Objective To explore the cause and prevention of postoperative rehaemorrhagia of hypertensive intracerebral hemorrhage.Methods The clinical data of 15 cases of rehaemorrhage after operation for hypertensive intracerebral hemorrhage were analyzed retrospectively.Results The incidence of postoperative rehaemorhage was 23.1%（15/65）,the mortality was 60.0%（9/15）;The main clinical manifestations were aggravated disturbance of consciousness,altered pupils and uncontrolled blood pressure.Conclusion The intraoperative thorough hemostasis and acute fluctuation of blood pressure after operation were important factors leading to rehaemorrhagia of hypertensive hemorrhage of basal nucleus.The essential factors to prevent rehemorrhage are selecting operating time reasonably,controlling bleeding properly during operation and keeping stable blood pressure after operation.