自发性脑出血的管理
Management of Spontaneous Intracerebral Haemorrhage.
作者信息
Swamy M N
机构信息
Classified Specialist (Surgery and Neurosurgery), Command Hospital (SC) Pune-411040.
出版信息
Med J Armed Forces India. 2007 Oct;63(4):346-9. doi: 10.1016/S0377-1237(07)80012-8. Epub 2011 Jul 21.
BACKGROUND
Management of spontaneous intracerebral haemorrhage (SICH) is still an enigma. The study was conducted to find out the most appropriate mode of treatment and other possible inclusion criteria's in addition to clot size.
METHODS
Sixty consecutive patients of SICH excluding bleeds due to arteriovenous malformations/aneurysm were included in the study. Patients with moderate and large bleeds, progressive neurological deficit and glasgow coma scale (GCS) of more than five were included in the surgical group and rest treated conservatively.
RESULT
Location of the bleed, other co-morbid conditions and GCS at presentations were more important guidelines than size of the bleed. Mortality was more in surgically treated group where cerebellar bleed fared well after evacuation.
CONCLUSION
Surgery is preferred in superficially located bleeds and cerebellar bleeds. Intra cranial pressure monitoring will help in categorizing the mode of treatment better than mere clot size.
背景
自发性脑出血（SICH）的治疗仍然是个谜。本研究旨在找出除血凝块大小外最合适的治疗方式及其他可能的纳入标准。
方法
本研究纳入了60例连续的自发性脑出血患者，排除因动静脉畸形/动脉瘤引起的出血。中度和大量出血、有进行性神经功能缺损且格拉斯哥昏迷量表（GCS）评分超过5分的患者被纳入手术组，其余患者接受保守治疗。
结果
出血部位、其他合并症情况以及就诊时的GCS评分比出血大小更重要。手术治疗组的死亡率更高，而小脑出血在清除血肿后恢复良好。
结论
对于表浅部位出血和小脑出血，手术治疗更佳。颅内压监测比单纯的血凝块大小更有助于更好地分类治疗方式。
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