摘要：

 目的 总结立体定向穿刺引流术治疗高血压小脑出血的体会。方法 13例高血压小脑出血患者均为2016年1月至2018年12月住院病例，接受立体定向穿刺引流术，采用Glasgow预后分级（GOS）评价预后。结果 发病至手术时间为（21.61±4.34）h，手术时间（1.53±0.67）h，术后血肿大部排空时间（54.39±8.10）h，拔除引流管时间（3.18±0.42）d；术后并发症包括肺部感染（3例）和消化道出血（2例），经对症治疗痊愈，1例死于再出血。平均随访8个月，GOS分级5级者9例、4级2例、3级1例、1级 1例。结论 立体定向穿刺引流术是一种较为安全、有效的治疗高血压小脑出血的外科手术方法。

关键词:  颅内出血, 高血压性, 小脑, 立体定位技术, 引流术

Abstract:

  Objective To summarize the experience of stereotactic puncture and catheter drainage in the treatment of hypertensive cerebellar hemorrhage. Methods Thirteen patients with hypertensive cerebellar hemorrhage were hospitalized from January 2016 to December 2018. The patients were treated with stereotactic puncture and catheter drainage via retrosigmoid approach. After operation, Glasgow Outcome Scale (GOS) was used to observe the curative effect. Results The average time from onset to operation was (21.61 ± 4.34) h, the average operation time was (1.53 ± 0.67) h, average evacuation time was (54.39 ± 8.10) h, and the average time of drainage tube removal was (3.18 ± 0.42) d. Postoperative complications included pulmonary infection (3 cases) and gastrointestinal hemorrhage (2 cases), which were recovery by symptomatic therapy, and one case died of recurrent hemorrhage. The survival cases were followed up for 8 months, GOS was 5 grade in 9 cases, 4 grade in 2 cases, 3 grade in one case and grade 1 in one case. Conclusions Stereotactic puncture and catheter drainage is a safe and effective method for the treatment of hypertensive cerebellar hemorrhage.

Key words:  Intracranial hemorrhage, hypertensive, Cerebellum, Stereotaxic techniques, Drainage