凝血功能障碍性脑出血的治疗

目的:探讨凝血功能障碍性脑出血的临床特点和治疗方法。方法:回顾性分析36例凝血功能障碍性脑出血患者的临床资料,所有患者入院后均常规纠正凝血功能障碍,包括静脉输注维生素K和新鲜冷冻血浆。10例行开颅血肿清除,16例行定向血肿穿刺引流,5例行脑室外引流,5例保守治疗。结果:出院时按GOS评分评定预后,预后良好5例,中残4例,重残6例,植物生存4例,死亡17例。结论:凝血功能障碍性脑出血病情进展快,再出血率和死亡率高。早期纠正凝血功能障碍及清除血肿,防止再出血是治疗的关键。

Treatment for cerebral hemorrhage due to coagulation disorders

Objective:To explore proper treatments for cerebral hemorrhage due to coagulation disorders.Methods:Clinical data of 36 cases of cerebral hemorrhage due to coagulation disorders were retrospectively analyzed.Except routine therapy to correct coagulation disorders,including intravenous administration of vitamin K and fresh frozen plasma,10 patients underwent hematoma evacuation,16 underwent hematoma puncture and drainage,5 cases had ventricular drainage,5 had conservative treatment.Results:According to GOS scores for prognosis,5 cases were evaluated as good,mediate degree disability in 6 cases,severedisability in 4 cases and death in 17 cases.Conclusion:Cerebral hemorrhage due to coagulopathy progressed rapidly,incidence of death is high if rebleeding occurred.Early treatment to correct the coagulation disorder and early hematoma removal are key steps to prevent rebleeding.