快速钻孔引流并开颅血肿清除救治高血压脑出血合并脑疝24例

目的探讨快速钻孔引流并开颅血肿清除治疗高血压脑出血合并脑疝的效果。方法对24例高血压脑出血合并脑疝的患者行快速微创钻孔血肿引流,随后行开颅血肿清除去骨瓣减压术,回顾性分析患者的临床资料及预后情况。结果 24例患者术后3个月按日常生活能力分级:良好14例,中度残疾5例,植物生存2例,死亡3例。结论快速微创钻孔血肿引流能快速缓解高血压脑出血合并脑疝患者的颅内压,减轻继发性脑干的损伤程度,有效降低了患者的病死率。

24 Cases of Hypertensive Cerebral Hemorrhage and Cerebral Hernia Treated by Rapid Drilling and Draining with Craniotomy Evacuation of Hematoma

Objective To explore the clinical effects of treating hypertensive cerebral hemorrhage and cerebral hernia by rapid drilling and draining with craniotomy evacuation of hematoma.Methods Twenty-four patients of hypertensive cerebral hemorrhage and cerebral hernia were treated in our hospital in recent years,and their clinical data were analyzed retrospectively.Results Cerebral hernia occurred in 24 patients,including unilateral mydriasis in 8 patients and bilateral mydriasis in 16 patients.All patiets were treated with rapid drilling and draining,craniotomy removing the hematoma,and decompression craniotomy.After 3 months,the patients were classified according to ADL:14 were cured,5 mildly disabled,2 in vegetative state,and 3 dead(mortality 12.5%).Conclusion Rapid drilling and draining to evacuate the hematoma can reduce the intracranial pressure and the secondary brainstem injuries in patients suffering from hypertensive cerebral hemorrhage and cerebral hernia.It effectively saves time to perform craniotomy on patients,resulting in a lower rate of death and disability.