高血壓腦出血術后再出血原因分析及防治對策

[摘要] 目的 探索高血壓腦出血術后再出血原因及防治對策。方法 選取2015年5月—2016年5月在該院住院手術治療高血壓腦出血的76例患者，術后發生再出血16例，對住院病例進行回顧與分析，總結其再出血原因并給予相應的防治對策。結果 通過統計數據發現發生高血壓腦出血術后再出血患者12例，發生率為21.05%，其中2例患者不配合擅自出院導致手術治療術后24 h內死亡，發生率為2.63%，同時術后記錄患者臨床表現發現患者雙側瞳孔大小變化、意識輕微障礙、血壓波動不定等。結論 通過分析導致術后再出血術原因與術者術中操作、患處止血不當以及術前是否使用凝血藥、手術選擇時機錯誤有關，但患者術后的體溫、血壓、患者情緒也有一定關系。高血壓腦出血術后在出血可能與臨床手術方式和術中操作以及患者術后生命體征檢測和情緒有關，臨床應合理使用降壓、鎮靜、抗凝血藥物，同時實時檢測患者術后生命體征。

[關鍵詞] 高血壓腦出血；術后再出血；原因分析；防治對策

[中圖分類號] R651 [文獻標識碼] A [文章編號] 1674-0742（2016）12（c）-0071-03

[Abstract] Objective To explore the causes and prevention measures of hypertensive cerebral hemorrhage after operation. Methods From May 2015 to May 2016 in our hospital 76 cases of surgical treatment of patients with hypertensive cerebral hemorrhage， 16 cases of postoperative rebleeding of hospitalized cases， review and analysis， summarize the causes of rebleeding and give the corresponding countermeasures. Results Through the statistical data found 12 patients with rebleeding after operation of hypertensive cerebral hemorrhage， the incidence rate was 21.05%， of which 2 patients did not leave the hospital with surgical treatment lead to death within 24 h after the operation， the incidence rate was 2.63%， and the postoperative records found in patients with clinical manifestations of patients with bilateral pupillary changes， consciousness disorder， slight fluctuations in blood pressure is not etc. Conclusion By analyzing the cause of causes and operation postoperative bleeding in operation in the operation， the affected area and whether preoperative hemostatic improper use of clotting drugs， surgery timing error， but the postoperative body temperature， blood pressure， patients also have a certain relationship. After operation of hypertensive cerebral hemorrhage in the bleeding may be associated with clinical surgery and intraoperative operation and postoperative vital signs and emotions， the clinical reasonable use of antihypertensive， sedation， anti clotting drugs， and real-time detection of the patients vital signs.

[Key words] Hypertensive cerebral hemorrhage； Postoperative hemorrhage； Cause analysis； Prevention and cure countermeasure

隨近些年生活水平提高和生活作息不規律導致患高血壓的患者逐年升高，但癥狀不明顯，血壓可呈階段性高漲。高血壓發生腦出血是由于血壓持續升高導致顱內動靜脈發生破裂引起顱內出血[1]。臨床治療高血壓腦出血主要采取開顱手術止血，清除血腫和血栓，但發生腦出血手術患者術后可由于諸多原因導致再次出血，嚴重可威脅患者生命[2]。……