立体定向抽吸术治疗自发性基底节血肿  

Computerized tomography-guided stereotaxic evacua-tion of spontaneous basal ganglion hematonas

作　　者：林岩崇[1] 诸葛启钏[1] 陈伟建[1] 郑荣远[1] 吴近森[1] 郭献忠[1] 瞿宣兴[1] 王小同[1] 林正章[1] 

机构地区：[1]温州医学院附属第一医院

出　　处：《中国危重病急救医学》1994年第6期343-345,共3页Chinese Critical Care Medicine

摘　　要：报告ＣＴ导向立体定向抽吸术治疗自发性基底节血肿８７例，其中男６４例，女２３例，平均年龄５６．４４岁。有高血压病史４９例，血管畸形２例，白血病１例，不明原因３５例。发病距手术时间最短４ｈ，最长２５天。＜７２ｈ为急性期，７２ｈ～１４天为亚急性期，＞１４天为慢性期。治疗结果：生存６６例，死亡２１例（病死率２４．１４％）。急性期血肿抽吸术后病死率低于亚急性期，且生存质量明显高于亚急性期和慢性期。ＧＣＳ指数５分以下或并发脑疝及破入脑室和丘脑血肿者，病死率明显增高。作者认为，基底节血肿患者应尽早争取在急性期手术；对血肿破入脑室者应同时行脑室引流术；脑血管畸形引起的血肿，抽吸术后需行血管造影，行显做外科手术切除畸形血管，达到根治。Computerized tomography (CT)-guided ste-reotaxic evacuation was used to treat 87 spontaneousbasal ganlion hematomas.Of the 87 patients ( 64males and 23 females with an average age of 56.44yrs),49 were due to hypertension, 2 cerebrovascularmalformation,1 leuukemia and 35 unknownorigin.The length between the occurrence ofhematomas and the surgical treatments was from 4hrs to 25 days.Among all patients , 66 survived and 21died with a mortality rate of 24.13%,The mortalityrate was lower in patients who received evacuationtreatments during the acute stage(<72 hrs)thanthose who received the treatments during thesubacute stage(72 hrs to 14 days).Moreover,the lifequality of the survivors who received evacuationtreatments during the acute stage was higher thanthose who received the treatments during thesubacute or chronie stage(>14 days).The mortalityrate was significantly high in patients with aGCS<(5,or with cerebral hernia and hematoma thatbroke into the ventricle and thalamus .We consider that basal ganglion hematoma should be treatedsurglcally as soon as possible in the acute stage ,ventricular drainage should be done simultaneouslywhen the hematoma breaks into the ventricle ,and angiography should be taken after the evacuation of hematoma due to vascular deformities and amicosugical exicision of the defomed blood vessels perfomed to attain an eradication.

关 键 词：基底节血肿 立体定向抽吸术 颅内血肿 

分 类 号：R651.150.5[医药卫生—外科学]