丘脑出血破入脑室的手术治疗及疗效分析
发布时间：2019-06-14 09:39
【摘要】：【目的】探讨单纯行侧脑室外引流术和经纵裂胼胝体入路血肿清除术两种外科手术方式治疗丘脑出血破入脑室的适应证及临床效果。【方法】回顾性分析苏州大学附属第一医院神经外科自2010年1月--2013年4月有完整临床资料的38例丘脑出血破入脑室的手术患者,其中行单纯侧脑室外引流25例,经纵裂胼胝体入路血肿清除13例。所有患者术后随访3个月--1年,采用日常生活活动能力(ADL)量表评估临床预后。【结果】按手术方式的不同进行结果统计:单纯行侧脑室外引流的患者中,ADL I级5例,II级8例,III级3例,IV级5例,死亡4例,死亡率为16%,死亡患者中有3例死于颅内感染,1例死于肺部感染并发多器官功能障碍衰竭;经纵裂胼胝体入路血肿清除的患者中,ADL II级2例,III级2例,IV级4例,死亡5例,死亡率为38.5%,其中4例死于肺部感染并发多器官功能障碍衰竭,1例死于颅内再出血。【结论】对于丘脑出血量30ml,仅破入单侧脑室者或患者意识障碍较轻,GCS评分超过8分者,采用单纯侧脑室外引流术治疗,效果明显;对于出血量≥30ml,且破入双侧侧脑室或全脑室铸型,或出血量未超过30ml,但患者意识障碍较重,GCS评分低于8分者,手术经纵裂胼胝体入路血肿清除更具优势。
[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.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1
本文编号：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.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1
【参考文献】
相关期刊论文 前1条
1 史永涛;王景新;;超早期小骨窗开颅治疗高血压脑出血[J];中国临床神经外科杂志;2007年07期
，本文编号：2499297
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2499297.html
最近更新
教材专著
