脑疝期高血压壳核出血的外科治疗

目的总结并探讨脑疝期高血压脑出血的手术方式及疗效。方法回顾性分析38例已发生脑疝的高血压出血患者,采用开颅血肿清除术,术后去骨瓣减压的手术方式治疗,总结评判其疗效。结果小脑幕切迹疝29例,术后存活25例（86%）,枕骨大孔疝9例,术后存活2例（22%）。结论脑疝期的高血压壳核出血,只要未进入枕骨大孔疝期,要积极手术救治,而发生枕骨大孔疝后,则要有选择性的手术。

Brain hernia time hypertension shell nucleus hemorrhage surgical treatment

Objective To summarize and to explore the period of hypertensive cerebral hemorrhage cerebral hernia surgical methods and efficacy.Methods Retrospective analysis of 38 cases of bleeding have occurred in patients with hypertensive cerebral hernia using cranial hematoma,decompressive craniectomy after the surgical treatment,concluding judge its efficacy.Results Of tentorial Herniation in 29 cases,postoperative survival in 25 cases,accounting for 86%,the foramen magnum herniation in 9 cases survived for 2 cases accounted for 22%.Conclusion Hernia hypertensive putamen hemorrhage period,if not enter the foramen magunm herniation period,surgical treatment should be positive,but occurs after the foramen magnum herniation,then be selective surgery.