应用6F动脉鞘作为硬通道治疗重症脑干出血的临床分析  

Clinical Analysis with Severe Hypertensive Brainstem Hemorrhage Treated by Putting in 6f Arterial Catheter as Hard Passage

作　　者：吴卫[1] 赵奇煌[1] 李涛[1] 

机构地区：[1]首都医科大学附属北京朝阳医院神经外科,北京100020

出　　处：《中国医药导刊》2007年第3期206-208,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨立体定向经横窦下乙状窦内侧入路留置6F动脉鞘作为硬通道治疗重症脑干出血的操作安全性和临床疗效。方法:选取我院神经外科2000～2005年治疗的重症脑干出血的26例患者为研究对象,其中有12例行立体定向经横窦下乙状窦内侧入路留置6F动脉鞘作为硬通道引流术,抽吸血肿后注入尿激酶溶解残留血块,持续引流,至血肿大部清除后拔除引流管。结果:12例手术患者术中未发生再出血。发病到拔管时间5～7天,血肿清除量占总量＞70%,3例于术后行侧脑室引流。死亡3例,9例存活,随访6个月后按日常生活能力评定,Ⅱ级1例,Ⅲ级5例,Ⅳ级2例,Ⅴ级(植物生存) 1例。结论:本手术方法对以往立体定向技术加以改进,简化了手术操作过程,提高了安全性,利于脑干功能的恢复。Objective： To explore the safety and curative effect of putting in 6F arterial catheter as hard passage under transverse sinus by stereotaxy to treat severe hypertensive brainstem hemorrhage. Metbods：We studied the 26 cases with severe brainstem hemorrhage treated in our hospital from 2000 to 2005. Them were 12 cases treated by putting in 6F arterial catheter as hard passage under transverse sinus and beside sigmoid sinus by stereotaxy. After local anesthesia, we fixed the Leksell - IV lathe - hedd. We putted in 6F arterial catheter as hard passage under transverse sinus and beside sigmoid sinus by stereotactic, eliminated the hemorrhage through the arterial catheter and then injected urokinase to infuse blood clot, opened the arterial catheter to drain continuously. When most of the hemorrhage was eliminated, we pull out the arterial catheter.Results： Nonc of the 12 cases rehaemon＇hagiaed when taking operation. The time between the occurrence of hemorrhage and pulling out the arterial catheter was 5 to 7 days. More than 70% of the hemorrhage was evacuated. 3 cases took ventricular drainage after operation. All of the cases lived at least for two weeks later, 3 cases died. 6 months later we graded the 9 cases alive, and the results was ： 1 case was of ADL - Ⅱ ,5ofADL- Ⅲ, 2ofADL-Ⅳ, 1 of ADL- Ⅴ .Conclusion： This methodimproved stereotactic technique and reduced the course of operation, improved safety, it was good for the recover of brainstem function.

关 键 词：立体定向置管 6F动脉鞘 脑干出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]