%0 Journal Article
%T 高血压基底节出血的治疗进展<br>Advances in the Treatment of Hypertensive Basal Ganglia Hemorrhage
%A 闫肖肖
%J Advances in Clinical Medicine
%P 2087-2093
%@ 2161-8720
%D 2025
%I Hans Publishing
%R 10.12677/acm.2025.1541157
%X 高血压基底节出血(HGBH)是高血压脑出血最常见的类型&#65292;具有高致残率和高死亡率。HGBH病理机制与长期高血压导致的豆纹动脉损伤(如脂质透明变性、微动脉瘤形成)及血压骤升引发的血管破裂有关&#65292;血肿的压迫、炎症反应和继发性脑损伤进一步加重神经功能缺损。HGBH分为保守治疗与手术治疗&#65292;根据患者的病情评估综合选择。保守治疗的重点是精准血压管理(如早期降压至130~140 mmHg)、颅内压控制(甘露醇、高渗盐水及亚低温治疗)、神经保护(依达拉奉、铁螯合剂)及并发症防治(深静脉血栓预防)。外科治疗以手术为主&#65292;包括小骨窗显微开颅术、神经内镜手术及机器人辅助立体定向穿刺术&#65292;治疗目的主要是以最小的创伤&#65292;高效清除血肿。目前&#65292;HBGH的未来治疗发展方向包括跨学科协作、新型药物研发及智能化精准诊疗体系的建立&#65292;以此改善患者神经功能预后及生活质量。<br>Hypertensive ganglionic-basal hemorrhage (HGBH) is the most common type of hypertensive intracerebral hemorrhage, characterized by high rates of disability and mortality. The pathological mechanisms of HGBH are associated with long-term hypertension-induced lenticulostriate artery damage (e.g., lipohyalinosis and microaneurysm formation) and acute blood pressure surges leading to vascular rupture. Subsequent neurological deficits are exacerbated by hematoma compression, inflammatory responses, and secondary brain injury. Treatment strategies for HGBH are categorized into conservative and surgical approaches, selected based on comprehensive patient assessment. Conservative management focuses on precise blood pressure control (e.g., early reduction to 130~140 mmHg), intracranial pressure regulation (mannitol, hypertonic saline, and mild hypothermia therapy), neuroprotection (edaravone, iron chelators), and complication prevention (deep vein thrombosis prophylaxis). Surgical interventions, including small bone window microcraniotomy, neuroendoscopic surgery, and robot-assisted stereotactic puncture surgery, aim to evacuate hematomas efficiently with minimal trauma. Future directions for HGBH treatment emphasize interdisciplinary collaboration, novel drug development, and intelligent precision diagnosis and treatment systems to improve neurological outcomes and quality of life.
%K 高血压基底节出血&#65292
%K 保守治疗&#65292
%K 手术<br>Hypertensive Ganglionic-Basal Hemorrhage
%K Conservative Treatment
%K Surgery
%U http://www.hanspub.org/journal/PaperInformation.aspx?PaperID=112056