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目的 :探讨妊娠高血压综合征合并脑出血的发病机理、分型、手术指征、手术方式的选择和合并症的防治 ,评价手术治疗妊娠高血压综合征合并脑出血的效果。方法 :根据不同个体 ,妊娠时间、血肿大小、出血量、血压高低及全身情况确定急诊手术或保守治疗。根据出血量选择手术方式 ,①出血量在 30～ 5 0ml时 ,清除血肿后 ,放橡皮片引流 ;②出血量在 5 0～ 70ml时 ,清除血肿后 ,待硅胶管引流 ;③基底节出血破入脑室者 ,无论血肿量多少 ,均在清除血肿后 ,作脑室外引流。结果 :治疗效果良好 11例 ,不良 2例 ,良好率 84 6 % ,不良率 15 4%。结论 :血肿清除术加脑室外引流术 ,是治疗妊娠高血压综合征合并脑出血的有效方法 ,具有恢复快 ,病死率少和致残率低的优点。
Objective: To investigate the pathogenesis of pregnancy-induced hypertension syndrome complicated by intracerebral hemorrhage, classification, surgical indications, choice of surgical methods and prevention and treatment of comorbidities, evaluate the effect of surgical treatment of pregnancy-induced hypertension syndrome with cerebral hemorrhage. Methods: According to different individuals, gestational age, hematoma size, amount of bleeding, blood pressure and systemic conditions to determine emergency surgery or conservative treatment. According to the choice of surgical methods of bleeding, ① bleeding in the 30 ~ 50ml, remove the hematoma, the rubber sheet drainage; ② bleeding in 50 ~ 70ml, clear the hematoma, to be silicone tube drainage; ③ basal ganglia hemorrhage broken Into the intracranial ventricle, regardless of the amount of hematoma, are in the removal of the hematoma, for brain drainage. Results: The treatment effect was good in 11 cases and poor in 2 cases, the good rate was 84.6% and the non-performing rate was 15.4%. Conclusion: Hematoma removal combined with cerebral ventricular drainage is an effective method for the treatment of pregnancy-induced hypertension with cerebral hemorrhage. It has the advantages of rapid recovery, low mortality and low morbidity.