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Selection of Therapeutic Opportunity and Operative Mode of Emergency Surgery for Spontaneous Intracerebral Hemorrhage

Author: HuJiShi
Tutor: LiuRongYao
School: Dalian Medical University
Course: Surgery
Keywords: spontaneous intracerebral hemorrhage emergency surgery opportunity method
CLC: R651.12
Type: Master's thesis
Year: 2009
Downloads: 109
Quote: 0
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Abstract


Objective:To study therapeutic opportunity and operative mode of emergency surgery in patients with spontaneous intracerebral hemorrhage(SICH).Method:Eighty-six patients with SCIH in our neurosurgical department from May 2005 to October 2008 were analyzed by using retrospective study.Patients were divided into ultra-early group (within 6h after onset),the early group (6-24hperiod) and delayed group (24-48h) according to operative oppor- tunity.There are sixty cases with Hypertensive intracerebral hemorrhage, including thirty cases by micro-craniotomy with small window of bone.12 cases by normal micro-craniotomy,18 cases by puncturation and drainage. Twenty six patients with Non-hypertensive intracerebral hemorrhage were consist of AVM(16cases) and aneurysm(10cases).All patients were accepted emergency surgery .Results:According to the International Glasgow Outcome Scale(GOS) classi- fication of prognosis score.In 60cases of hypertensive intracerebral hem- orrhage group,12cases(20.0%)are good recovery,17cases(28.3%)are mild disability,13cases(21.7%) are severe disability;7cases(11.7%)are survival as vegetative state,11cases(18.3%)were dead.In 26cases of Nonhyper- tensive cerebral hemorrhage group,11cases(42.3%)are good recovery,6 cases(23.0%)are mild disability,4cases(15.4%)are severe disability,2cases (7.7%)are survival as vegetative state,3cases(11.5%)were dead. Conclusion:1.The effect of ultra-early or early surgical group is better than delayed surgical group,It is a good therapeutic opportunity。2.The emergency surgical programs should follow Individual tratment ac- cording to the specific circumstances,imaging characteristics and a compre- hensive assessment of patient.Mastering surgical indications Strictly and choose the best time for surgery,using appropriate surgical approach and skilled surgical technique,which will be able to save most of patients with intracranial hemorrhage and improve their quality of life.

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Brain > Cerebrovascular surgery
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