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1、【摘要】目的:探讨自发性脑叶出血的手术治疗方法和策略,评估救治效果。方法:回顾总结60例脑叶出血手术患者,采用个体化手术方法的治疗经验,其中钻孔引流术19例,开颅手术41例。术前脑血管影像检查36例,手术时机3〜6h、6〜12h和>12h的患者分别为19、23、18例。结果:【关键词】脑叶出血;钻孔引流;开颅手术;手术时机TheSurgicalMethodsandStrategiesonSpontaneousBrainHemorrhage/YUYong-qiang,LONGQing-shan,LIANGQuan,etal.//MedicalI
2、nnovationofChina,2014,11(16):011-015[Abstract]Objective:Toexplorethesurgicalmethodsandstrategiesonspontaneousbrainhemorrhage.Method:Accordingtoindividualoperationexperience,60brainhemorrhagesurgerypatientswereretrospectivesummarized,36casesweregivenpreoperativecerebralimagi
3、ng,60patientsweredividedintotwogroups,19casesfordrillingdrainagegroup,41casesforsurgicaloperationgroups・Accordingoperationtime,thepatientsweredividedintothreegroups:3-6h,6-12hand>12hgroupwererespectivelyfor19,23,18cases.Result:Aftersurgery,hematomalosswasashighas79.20%,post
4、operativerebleedingratewas15.00%,postoperativerebleedingrateof6-12hand>12hwereobviouslylowerthan3-6hsurgicalpatients(P<0.05),butnervefunctionrecoverof7days,4weekswereworsethan3-6hsurgery(P<0.05),andsignificantlyimprovedthanpreoperativeandpostoperative1dayaftersurgery(P<0.05
5、),followedupfor6-12months,28casesrecoveredwell(46.67%)and20casesmoderatedisability(33.33%),6casesseveredisabilities(10.00%),plantsurvivalfor1case(1.67%),2casesdied(3.33%),givenuptreatmentfor3cases(5.00%);ADL1for31cases(50.67%),ADLIIfor17cases(28.33%),ADLIIIfor10cases(16.67%
6、),ADLIVfor2cases(3.33%);surgeryeffectiveratewasashighas96.67%・Conclusion:Operationofspontaneousintracerebralhemorrhageshouldbegivenpreoperativecerebrovascularimagingandusedmicroscope,chooseoperationmethodsandstrategiescorrectlybyvolumeofhematoma,bleedingcauseandlocation,itw
7、illgetthebestrecoveryeffectonhemostasisoperationandnervefunctionbythewayofgraspoperationtimeearlybutnon-ultraearlyoperationaccurately.【Keywords】Cerebrallobehemorrhage;Drillingdrainage;Surgicaloperation;OperationtimeFirst-author,saddress:TheThirdPeople'sHospitalofHuizhou,Hui
8、zhou516002,Chinadoi:10.3969/j.issn.l674-4985.2014.16.004自发性脑叶出血,即皮质下白质岀血,是脑出血的一种特殊