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当前位置：国际外科研究杂志 > 2024年 7卷 (1)期

Open Access Article

International Journal of Surgical Research. 2024; 7: (1) ; 16-21 ; DOI: 10.12208/j.ijsr.20240004.

Surgical intervention and prognostic evaluation of hypertensive intracerebral hemorrhage
高血压脑出血的外科干预与预后评估

作者： 叶青 *

青海大学青海西宁

*通讯作者：叶青,单位：青海大学青海西宁；

发布时间: 2024-12-31 总浏览量: 57

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摘要

高血压脑出血（HICH）是全球范围内致残和致死率极高的脑血管疾病，其外科干预策略与预后评估对改善患者生存质量至关重要。本文系统探讨了HICH的病理生理机制、临床表现及诊断方法，强调CT扫描在急性期诊断中的核心作用。外科干预策略包括紧急手术指征（如出血量＞30ml或GCS评分＜8分）、微创手术技术（内窥镜与机器人辅助技术）及开颅手术的适应症（深部血肿或占位效应显著）。治疗原则以多学科协作为基础，注重术中血压控制和术后并发症管理（如颅内压调控、血管痉挛处理）。预后评估结合GCS、NIHSS等临床指标，分析出血量、年龄及手术时机等关键因素。未来研究方向聚焦新兴外科技术、预后模型优化及高血压防控政策改进。

关键词： 高血压脑出血；外科干预；预后评估；微创手术；开颅手术

Abstract

Hypertensive intracerebral hemorrhage (HICH) is a cerebrovascular disease with extremely high disability and mortality rates worldwide. Its surgical intervention strategy and prognostic evaluation are crucial to improving the quality of life of patients. This article systematically discusses the pathophysiological mechanism, clinical manifestations and diagnostic methods of HICH, emphasizing the core role of CT scanning in acute diagnosis. Surgical intervention strategies include emergency surgical indications (such as blood loss > 30ml or GCS score <8 points), minimally invasive surgical techniques (endoscopic and robot-assisted techniques) and indications for craniotomy (deep hematoma or significant space-occupying effect). The treatment principle is based on multidisciplinary collaboration, focusing on intraoperative blood pressure control and postoperative complication management (such as intracranial pressure regulation and vasospasm treatment). Prognostic evaluation combines clinical indicators such as GCS and NIHSS to analyze key factors such as blood loss, age and timing of surgery. Future research directions focus on emerging surgical techniques, prognostic model optimization and improvement of hypertension prevention and control policies.

Key words： Hypertensive intracerebral hemorrhage; Surgical intervention; Prognosis assessment; Minimally invasive surgery; Craniotomy

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引用本文

叶青, 高血压脑出血的外科干预与预后评估[J]. 国际外科研究杂志, 2024; 7: (1) : 16-21.

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