高血压脑出血术后再出血的高危因素及其预防

目的 总结高血压脑出血(HCH)术后再出血的危险因素和预防措施。方法 连续记录76例HCH手术患者的病史、体征、诊断、临床分级、治疗方法及病理改变。并对治疗结果进行统计分析。结果 发生再出血8例,其出血的高危因素有长期高血压病史,脑出血后早期即行手术,术中未能发现主要的出血灶或止血不可靠,以及术后未能控制高血压等。结论 术中对主要的出血动脉作可靠电凝止血、术后有效地控制血压是预防再出血的关键。

The risk factors and prevention of rebleeding after craniotomy for evacuation of hypertensive cerebral hematoma

Objective To summarize the experiences for setting the preventive management of rebleeding after craniotomy for evacuation of hypertensive cerebral hematoma. Methods The clinical records were studied. The procedures of caraniotomy and the pathologies of hematoma and cerebral vascular sclerosis were analyzed. The possible factors causing rebleeding were discussed. Results There were 8 cases having rebleeding after craniotomy. The significant risk factors might be related with long history of hypertension,craniotomy done for e-vacuation of hematoma at early stage. The vessels responsible for hematoma were not detected or failed to make successful bleeding control and antihypertensive measurements were not effective during or after operation. Conclusions Assuring the bleeding control and applying adequate antihypertensive measurements during and after operation are important factors for the prevention of rebleeding after the evacuation of cerebral hematoma.