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  • 葛爱青,张丹枫,陈吉钢,于明琨,胡国汉,侯立军,卢亦成,王君玉.长期口服阿司匹林高血压颅内出血患者的手术治疗[J].第二军医大学学报,2018,39(11):1292-1294    [点击复制]
  • GE Ai-qing,ZHANG Dan-feng,CHEN Ji-gang,YU Ming-kun,HU Guo-han,HOU Li-jun,LU Yi-cheng,WANG Jun-yu.Surgical treatment of hypertensive intracerebral hemorrhage in patients with long-term oral aspirin administration[J].Acad J Sec Mil Med Univ,2018,39(11):1292-1294   [点击复制]
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长期口服阿司匹林高血压颅内出血患者的手术治疗
葛爱青1,2,张丹枫1,陈吉钢1,于明琨1,胡国汉1,侯立军1,卢亦成1,王君玉1*
0
(1. 海军军医大学(第二军医大学)长征医院神经外科, 上海市神经外科研究所, 上海 200003;
2. 国家发展和改革委员会门诊部, 北京 100824
*通信作者)
摘要:
目的 探讨长期口服阿司匹林高血压脑出血患者的手术治疗方案及效果。方法 2014年8月-2016年8月我科手术治疗的长期服用阿司匹林高血压脑出血患者共10例,收集其临床资料,分析手术方式与效果,进行总结。结果 5例患者行开颅血肿清除术,其中3例为急诊手术。急诊手术者术中止血困难,1例予术中输血后好转。2例行急诊手术者有大小不一再出血。术后3个月患者均存活,其中GOS评分2分者3例,3分者1例,4分者1例。5例行急诊穿刺引流术者,术中发现血肿易吸出,颜色偏鲜红。2例出现术后血肿扩大。2例患者分别在发病后14天及37天死亡,余患者术后3个月GOS评分均为2分。结论 长期口服阿司匹林高血压脑出血患者初发出血量大,应停服阿司匹林,给予输注血浆或血小板。病情危重者应根据患者具体情况选择不同手术方式进行治疗。
关键词:  阿司匹林  高血压性颅内出血  血肿清除术  引流术
DOI:10.16781/j.0258-879x.2018.11.1292
投稿时间:2018-06-22修订日期:2018-09-28
基金项目:
Surgical treatment of hypertensive intracerebral hemorrhage in patients with long-term oral aspirin administration
GE Ai-qing1,2,ZHANG Dan-feng1,CHEN Ji-gang1,YU Ming-kun1,HU Guo-han1,HOU Li-jun1,LU Yi-cheng1,WANG Jun-yu1*
(1. Department of Neurosurgery, Shanghai Neurosurgical Institute, Changzheng Hospital, Navy Medical University(Second Military Medical University), Shanghai 200003, China;
2. Outpatient Department of National Development and Reform Commission, Beijing 100824, China
*Corresponding author)
Abstract:
Objective To explore the application of surgical treatment of hypertensive intracerebral hemorrhage (hICH) in patients with long-term oral aspin administration; Methods: In this retrospective study, we included 10 (hICH) patients with long-term oral aspin administration who were treated with operation in Neurosurgical Department of Changzheng Hospital of Second Military University from Aug. 2014 to Aug. 2016. Data Concerning patients’ clinical demographics as well as 3-month follow up were collected. Surgical procedures and effects for hICH were analyzed together. Results: 5 patients underwent craniotomy, among which 3 were conducted by emergency operation. There 3 patients had difficulties in surgical hemostasis and 2 of them suffered rebleeding after operation. All of these patients survived in 3-month follow-up with Glasgow Outcome Scale (GOS) between 2-4. 5 patients had emergency drainage for hematoma and the blood was easy to drain out. 2 patients died in 14 and 37 days, and the rest had a GOS of 2 in 3 months. Conclusion: hICH patients with long-term oral aspin administration tended to have larger hematoma volume. Aspin should be stopped and it’s favorable to have blood transfusion before individualized surgery.
Key words:  aspirin  hypertensive intracerebral hemorrhage  haematoma removal  drainage