[1]陈 静 滕晓华 向健威 刘 宇 张佳兴 姜 峰 张汀琼 杜进兵.高血压性脑干出血的个体化手术治疗[J].中国临床神经外科杂志,2020,(04):218-220.[doi:10.13798/j.issn.1009-153X.2020.04.009]
 CHEN Jing,TENG Xiao-hua,XIANG Jian-wei,et al.Individualized surgical treatment based on volume and location of hemotoma for hypertensive brainstem hemorrhage[J].,2020,(04):218-220.[doi:10.13798/j.issn.1009-153X.2020.04.009]
点击复制

高血压性脑干出血的个体化手术治疗()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年04期
页码:
218-220
栏目:
论著
出版日期:
2020-04-30

文章信息/Info

Title:
Individualized surgical treatment based on volume and location of hemotoma for hypertensive brainstem hemorrhage
文章编号:
1009-153X(2020)04-0218-03
作者:
陈 静 滕晓华 向健威 刘 宇 张佳兴 姜 峰 张汀琼 杜进兵
410003 长沙,中国人民解放军联勤部队第921医院神经外科(陈 静、滕晓华、向健威、刘 宇、张佳兴、姜 峰、张汀琼);430070 武汉,中国人民解放军中部战区总医院卫勤部(杜进兵)
Author(s):
CHEN Jing1 TENG Xiao-hua1 XIANG Jian-wei1 LIU Yu1 ZHANG Jia-xing1 JIANG Feng1 ZHANG Ting-qiong1 DU Jin-bing2.
1. Department of Neurosurgery, The 921st Hospital of Joint Logistics Force, PLA, Changsha 410003, China; 2. Medical Service Department, General Hospital of Central Theater, PLA, Wuhan 430070, China
关键词:
高血压性脑干出血显微手术手术指征手术方法
Keywords:
Hypertensive brainstem hemorrhage Individualized surgical treatment Clinical effect
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2020.04.009
文献标志码:
A
摘要:
目的 探讨高血压性脑干出血的显微手术治疗的手术指征、手术技巧、手术方法和预后。方法 回顾性分析2011年 1月至2018年12月收治的54例高血压性脑干出血的临床资料。根据出血量及出血部位采用个体化手术治疗。结果 术后3个月,按GOS评分:脑室穿刺治疗的30例中,8例恢复良好,12例中残或重残,4例植物状态生存,6例死亡;开颅手术治疗的20例中,3例恢复良好,5例中残或重残,5例植物状态生存,7例死亡;脑干穿刺治疗的4例中,中残2例,重残1例,植物状态生存1例。结论 根据出血量及出血部位采用不同的方法治疗高血压性脑干出血,效果良好。
Abstract:
Objective To explore the surgical indications, surgical techniques, surgical methods and surgical efficacy for hypertensive brainstem hemorrhage. Methods The clinical data of 54 patients with hypertensive brainstem hemorrhage who were admitted to our hospital from January 2011 to December 2018 were retrospectively analyzed. According to the volume and location of hemotoma, individualized surgical treatment was used. The prognosis was assessed according to the GOS score 3 months after the operation. Results Of 30 patients treated with ventricular puncture, 8 patients were recovered well, 12 were moderately or severely disabled, 4 survived in vegetative state, and 6 died. Of 20 patients treated with craniotomy, 3 patients were recovered well, 5 were moderately or severely disabled, 5 survived in vegetative state, and 7 died. Of 4 patients treated with brainstem puncture treatment, 2 were moderate disability, 1 was severe disability, and 1 was vegetative state. Conclusion For hypertensive brainstem hemorrhage, the treatment method should be chosen according to the volume and location of the homatoma, which can obtain good clinical effects.

参考文献/References:

[1] 潘新发,赵希坤,詹仁雅,等. 原发性脑干出血患者预后的 影响因素分析[J]. 中国临床神经外科杂志,2014,19(6): 325-327.
[2] 陈立华,徐如祥. 高血压脑干出血的微创治疗[J/CD]. 中华 神经创伤外科电子杂志,2016,2(4):252-254.
[3] 张先斌,杨宏武,孙树杰,等. 方体定向软通道微创穿刺治 疗高血压性小脑出血患者的效果[J]. 医疗装备,2018,31 (18):1-3.
[4] 范学政,游 潮. 国内高血压脑出血微创血肿清除手术治 疗现状及趋势[J]. 中华神经医学杂志,2017,16(9):956- 961.
[5] Murata Y, Yamaguchi S, Kajikawa H, et al. Relationship between the clinical manifestations, computed tomographic findings and the outcome in 80 patients with primary pontine hemorrhage [J]. J Neurol Sci, 1999, 167: 107-108.
[6] 陈立华,魏 群,徐如祥,等. 原发性高血压脑干出血的微 创手术治疗[J]. 临床神经外科杂志,2015,12(5):349- 353.
[7] Groen RJ, van Alphen HA. Operative treatment of sponta- neous spinal epidural hem atom as: a study of the factors determining postoperative outcome [J]. Neurosurgery, 1996, 39: 494-508.
[8] 张银清,叶金练,吴文彬,等. 微创锥颅手术治疗32例高 血压性重症脑干出血[J]. 中国微侵袭神经外科杂志, 2017,22(12):562-563.
[9] 雷 丹,杨国平,刘超轶,等. C臂X光机下钻孔引流术治 疗重型脑干出血[J]. 中国临床神经外科杂志,2018,23 (10):679-681.

相似文献/References:

[1]林国中 王振宇 马长城 赵 薇.神经电生理监测下显微手术切除脊髓髓内肿瘤[J].中国临床神经外科杂志,2015,(11):647.[doi:10.13798/j.issn.1009-153X.2015.11.003]
 LIN Guo-zhong,WANG Zhen-yu,MA Chang-cheng,et al.Clinical value of intraoperative electrophysiological monitoring to microsurgery for intramedullary spinal tumors[J].,2015,(04):647.[doi:10.13798/j.issn.1009-153X.2015.11.003]
[2]谢京城 王振宇 陈晓东.骶管终丝脊膜囊肿合并脊髓拴系综合征的诊断和治疗[J].中国临床神经外科杂志,2015,(11):651.[doi:10.13798/j.issn.1009-153X.2015.11.004]
 XIE Jing-cheng,WANG Zhen-yu,CHEN Xiao-dong.Diagnosis and surgical treatment of sacral spinal meningeal cysts of fila terminale complicated with tethered spinal cord syndrome[J].,2015,(04):651.[doi:10.13798/j.issn.1009-153X.2015.11.004]
[3]于 涛 黄正通 王振宇.椎管内脊膜囊肿的临床特征和治疗方法[J].中国临床神经外科杂志,2015,(11):654.[doi:10.13798/j.issn.1009-153X.2015.11.005]
 YU Tao,HUANG Zheng-tong,WANG Zhen-yu.Clinical features and treatment of intraspinal arachnoid cysts[J].,2015,(04):654.[doi:10.13798/j.issn.1009-153X.2015.11.005]
[4]谢宝树 王 宇 贾 锋 张 林 殷玉华.神经电生理监测下显微手术治疗成人脊髓栓系综合征[J].中国临床神经外科杂志,2015,(11):658.[doi:10.13798/j.issn.1009-153X.2015.11.006]
 XIE Bao-shu,WANG Yu,JIA Feng,et al.Intraoperative electrophysiological monitoring-guided microsurgery on tethered spinal cord syndrome in adults[J].,2015,(04):658.[doi:10.13798/j.issn.1009-153X.2015.11.006]
[5]赵东升 王正君 孙刚锋 费 舟 姬西团 李 娟 万晓强.椎管内畸胎瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
 ZHAO Dong-sheng,WANG Zheng-jun,SUN Gang-feng,et al.Dignosis and treatment of intraspainal teratomas[J].,2015,(04):661.[doi:10.13798/j.issn.1009-153X.2015.11.007]
[6]陈晓东 于 涛 王振宇.脊髓髓内神经鞘瘤的诊断与治疗[J].中国临床神经外科杂志,2015,(11):670.[doi:10.13798/j.issn.1009-153X.2015.11.010]
 CHEN Xiao-dong,YU Tao,WANG Zhen-yu.Diagnosis and treatment of intramedullary spinal schwannomas[J].,2015,(04):670.[doi:10.13798/j.issn.1009-153X.2015.11.010]
[7]马 磊 张海红 张 威 衡立君 孙树凯 贾 栋.眶上锁孔入路手术切除前颅底脑膜瘤的临床效果[J].中国临床神经外科杂志,2015,(11):680.[doi:10.13798/j.issn.1009-153X.2015.11.013]
 MA Lei,ZHANG Hai-hong,ZHANG Wei,et al.Microsurgery through supraorbital keyhole approach for anterior cranial fossa meningiomas[J].,2015,(04):680.[doi:10.13798/j.issn.1009-153X.2015.11.013]
[8]李春坡 郑 军 李海元 边 涛 韩安国.侧脑室三角区小型脑膜瘤的显微外科治疗[J].中国临床神经外科杂志,2015,(11):694.[doi:10.13798/j.issn.1009-153X.2015.11.018]
[9]张兆斯 但 炜 王 刚 周 超 孙 超 谢延风 石全红 詹 彦.咪达唑仑和丙泊酚诱导麻醉对继发性癫痫术中皮层脑电图的影响[J].中国临床神经外科杂志,2016,(05):261.[doi:10.13798/j.issn.1009-153X.2016.05.002]
 ZHANG Zhao-si,DAN Wei,WANG Gang,et al.Effects of midazolam or propofol used for induction of anesthesia on intraoperative ECoG in patients with secondary epilepsy[J].,2016,(04):261.[doi:10.13798/j.issn.1009-153X.2016.05.002]
[10]赵 平 王雄伟 汪 雷 马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
 ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(04):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]

备注/Memo

备注/Memo:
通讯作者:杜进兵,E-mail:149383072@qq.com (2019-03-25收稿,2020-03-25修回)
更新日期/Last Update: 2020-04-10