脑出血定向置管治疗中吸引管与颅脑相关血管构筑关系的初步探讨  

A pilot study of the relationship between the drainage cannula and the cerebral angioarchitecture in patients receiving stereotactic cannula placement for hypertensive intracerebral hemorrhage

作　　者：骆锦标[1] 孙树杰[3] 全伟[1] 曹志凯[1] 彭彪[1] 谢琦[2] 魏新华[2] 吕建平[1] 肖国才[1] 

机构地区：[1]广州市第一人民医院神经外科,510160 [2]广州市第一人民医院影像科,510160 [3]大连医科大学第二附属医院急诊科,大连116023

出　　处：《中华神经医学杂志》2008年第10期1054-1056,共3页Chinese Journal of Neuromedicine

基　　金：国家十一五科技支撑计划（2007BA107A13）

摘　　要：目的初步探讨应用简化式定向置软管吸引术救治脑出血中吸引管与颅脑相关血管构筑的关系，以了解所有类似手术方法的科学性、安全性。方法对63例高血压脑出血患者行简化式定向置软管吸引术治疗，术后病情稳定或血肿引流干净后，拔管前行CT脑血管造影重建（CTA、CTV），了解吸引管血肿穿刺路径、吸引管与颅脑相关血管构筑的关系。结果对所有高血压脑出血患者在定向置管术后CTA、CTV分析发现，吸引管在穿刺血肿靶点路径中均可安全滑过相关颅脑动脉及静脉，吸引管位置准确，引流效果好，术后恢复快，未见置管及引流过程中引流管明显损伤重要相关颅脑血管。结论简化式定向置软管血肿吸引术中所选用的一次性软性引流管设计科学、合理，该手术是定向准确、微创、安全有效、廉价简便的救治高血压脑出血的一种方法。Objective To investigate the clinical outcome of patients receiving stereotactic cannula placement for hypertensive intracerebral hematoma drainage and the relationship between the drainage cannula and the cerebral angioarchitecture. Methods Sixty-three patients with hypertensive intracerebral hematoma underwent operations for stereotactic placement of a soft tube for hematoma drainage. CT angiography and CT venography were performed prior to cannula withdrawal after the patients＇ condition was stabilized or complete hematoma drainage. The relationship between the drainage cannula, cerebral angioarchitecture and the entry route of the cannula were observed. Results Postoperative CT angiography and CT venography showed that the entry route of the cannula allowed safe passage of the carmula along the cerebral arteries and veins, and the position of the carmula was accurate in all the patients. Satisfactory hematoma drainage and good postoperative recovery was achieved in all the patients, and no significant injuries to the adjacent cerebral arteries or veins occurred in these cases. Conclusion Stereotactic cannula placement with the minimally invasive technique for hemotoma drainage causes minimal injury and is safe, effective, cost-effective and convenient for treatment of hypertensive intracerebral hematoma.

关 键 词：高血压脑出血 定向置管 脑血管造影 

分 类 号：R743.34[医药卫生—神经病学与精神病学]