脑出血吸收期包膜形成与持续性水肿

目的　探讨脑出血吸收期包膜形成与持续性脑水肿的病理改变和临床特点。方法　分析 1 2例中、小量脑出血患者的临床资料。结果　血肿吸收液中K+ 、Na+ 水平与血液比较无明显差异 ;术中见血肿几乎完全液化 ,腔内压力极高 ,周围脑组织呈现灰白色 ,水含量增多 ,血肿包膜为脑组织大量陈旧性出血和新生毛细血管、弥漫性及袖套状淋巴细胞浸润 ;患者预后良好 1 1例 ,死亡 1例。结论　中、小量脑出血可在吸收期以后出现包膜与持续性脑水肿并存 ,而导致恶性颅高压 ,治疗应采取联合脱水及对较大包膜性血肿进行手术治疗。

Capsule formation and continuous cerebral edema in absorption period of cerebral hemorrhage

Objective To investigate capsule formation and the pathological change and clinical characteristics of continuous cerebral edema in absorption period of cerebral hemorrhage.Methods The clinical data of 12 cases with small and intermediate volume cerebral hemorrhage were analysed.Results There was no significant difference between K +,Na + level in hematoma absorption solution and K +,Na + level in blood;during the operation hematoma was found to be as good as liquidized,the pressure in the cavity increased greatly while the peripheral cerebral tissues appeared gray with increased water content.Hematoma capsule included great remote hemorrhage in cerebral tissues and diffuse and cuffing infiltration of neoformative capillaries and lymphocytes;eleven cases had good pregnosis while one case died.Conclusion Capsule formation and continuous cerebral edema may occur at the same time after the absorption period for small and intermediate volume cerebral hemorrhage,which can lead to malignant intracranial hypertention.The combined dehydrating and operation on larger capsule edema may be adopted in the treatment.