丘腦出血破入腦室的手術(shù)治療及療效分析
發(fā)布時(shí)間：2019-06-14 09:39
【摘要】：【目的】探討單純行側(cè)腦室外引流術(shù)和經(jīng)縱裂胼胝體入路血腫清除術(shù)兩種外科手術(shù)方式治療丘腦出血破入腦室的適應(yīng)證及臨床效果�！痉椒ā炕仡櫺苑治鎏K州大學(xué)附屬第一醫(yī)院神經(jīng)外科自2010年1月--2013年4月有完整臨床資料的38例丘腦出血破入腦室的手術(shù)患者,其中行單純側(cè)腦室外引流25例,經(jīng)縱裂胼胝體入路血腫清除13例。所有患者術(shù)后隨訪3個(gè)月--1年,采用日常生活活動(dòng)能力(ADL)量表評(píng)估臨床預(yù)后�！窘Y(jié)果】按手術(shù)方式的不同進(jìn)行結(jié)果統(tǒng)計(jì):單純行側(cè)腦室外引流的患者中,ADL I級(jí)5例,II級(jí)8例,III級(jí)3例,IV級(jí)5例,死亡4例,死亡率為16%,死亡患者中有3例死于顱內(nèi)感染,1例死于肺部感染并發(fā)多器官功能障礙衰竭;經(jīng)縱裂胼胝體入路血腫清除的患者中,ADL II級(jí)2例,III級(jí)2例,IV級(jí)4例,死亡5例,死亡率為38.5%,其中4例死于肺部感染并發(fā)多器官功能障礙衰竭,1例死于顱內(nèi)再出血�！窘Y(jié)論】對(duì)于丘腦出血量30ml,僅破入單側(cè)腦室者或患者意識(shí)障礙較輕,GCS評(píng)分超過(guò)8分者,采用單純側(cè)腦室外引流術(shù)治療,效果明顯;對(duì)于出血量≥30ml,且破入雙側(cè)側(cè)腦室或全腦室鑄型,或出血量未超過(guò)30ml,但患者意識(shí)障礙較重,GCS評(píng)分低于8分者,手術(shù)經(jīng)縱裂胼胝體入路血腫清除更具優(yōu)勢(shì)。
[Abstract]:[Objective] To study the indications and clinical effects of the two surgical methods for the treatment of thalamic hemorrhage into the ventricle by the external drainage of the lateral ventricle of the lateral ventricle and the removal of the subthalamic hemorrhage. [Methods] A retrospective analysis of 38 cases of thalamic hemorrhage with complete clinical data from January 2010 to April 2013 in the First Affiliated Hospital of Suzhou University was analyzed retrospectively. [Results] According to the different results of operation, there were 5 cases of ADL grade I,8 cases of grade II,3 cases of grade III,5 cases of grade IV,4 cases of death,16% of death rate,3 cases of death with intracranial infection,1 case of pulmonary infection and multiple organ dysfunction failure,2 cases of ADL II,2 cases of grade III,4 cases of IV,5 cases of death, and 38.5% of death rate, among which 4 cases died of pulmonary infection and multiple organ dysfunction, and one died of intracranial rebleeding. [Conclusion] For the thalamic hemorrhage volume of 30 ml, only the single lateral ventricle or the patient is less aware of the disorder, the GCS score is more than 8, the lateral lateral ventricle or full-ventricular casting is broken, or the amount of blood loss is not more than 30 ml.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1
本文編號(hào)：2499297
[Abstract]:[Objective] To study the indications and clinical effects of the two surgical methods for the treatment of thalamic hemorrhage into the ventricle by the external drainage of the lateral ventricle of the lateral ventricle and the removal of the subthalamic hemorrhage. [Methods] A retrospective analysis of 38 cases of thalamic hemorrhage with complete clinical data from January 2010 to April 2013 in the First Affiliated Hospital of Suzhou University was analyzed retrospectively. [Results] According to the different results of operation, there were 5 cases of ADL grade I,8 cases of grade II,3 cases of grade III,5 cases of grade IV,4 cases of death,16% of death rate,3 cases of death with intracranial infection,1 case of pulmonary infection and multiple organ dysfunction failure,2 cases of ADL II,2 cases of grade III,4 cases of IV,5 cases of death, and 38.5% of death rate, among which 4 cases died of pulmonary infection and multiple organ dysfunction, and one died of intracranial rebleeding. [Conclusion] For the thalamic hemorrhage volume of 30 ml, only the single lateral ventricle or the patient is less aware of the disorder, the GCS score is more than 8, the lateral lateral ventricle or full-ventricular casting is broken, or the amount of blood loss is not more than 30 ml.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 史永濤;王景新;;超早期小骨窗開顱治療高血壓腦出血[J];中國(guó)臨床神經(jīng)外科雜志;2007年07期
，本文編號(hào)：2499297
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