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[高血压性脑出血的外科治疗]

[Surgical treatment of hypertensive intracerebral hemorrhages].

作者信息

Chebotareva N M

出版信息

Zh Nevropatol Psikhiatr Im S S Korsakova. 1977;77(11):1680-5.

PMID:596036
Abstract

A total of 95 patients operated for hypertensive intracerebral hemorrhages during the first 3 days following the stroke were studied. The average amount of the postoperative lethal outcome was 46% and in the last years--26%. The analysis of the observations demonstrated that in hemorrhages into the cerebral hemispheres (the most frequent hemorrhages) a vital prognosis and evidences for operation are mainly determined by the depth of hematoma position in relation to the internal capsule, a degree of blood hemorrhages into the ventricles, state of brain magistral arteries (carotic, vertebral-basilar) and the brain stem. Cerebral angiography is a very important examination method facilitating the determination of a hemorrhage cause, its localization, expressiveness of dislocation phenomena, as well as the character and degree of changes of the brain magistral arteries (atherosclerotic stenoses, exaggerations, ansae, hypoplasia). The determination of a vital prognosis of a stroke with conservative and surgical treatment with the aid of a computer permits to solve the problem of evidences for an operation more basically.

摘要

对95例在中风后前3天接受高血压脑出血手术的患者进行了研究。术后致死率平均为46%,近年来为26%。观察分析表明,在脑半球出血(最常见的出血类型)中,生命预后和手术指征主要取决于血肿相对于内囊的位置深度、血液流入脑室的程度、脑主要动脉(颈动脉、椎基底动脉)的状态以及脑干情况。脑血管造影是一种非常重要的检查方法,有助于确定出血原因、其定位、移位现象的明显程度,以及脑主要动脉的变化特征和程度(动脉粥样硬化狭窄、扩张、袢、发育不全)。借助计算机确定中风保守治疗和手术治疗的生命预后,能够更根本地解决手术指征问题。

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