CT监测下硬通道技术治疗基底节脑出血  

Treatment of basal ganglia hemorrhage by transcranial puncture under CT monitoring

作　　者：赵宪林[1] 焦德生 高飞[1] 李子强[1] 陈世伟[1] 张蜂[1] 刘永军[1] 王庭忠[1] 杜敬华[1] 刘国军[1] 关永昌[1] 

机构地区：[1]中国医科大学第四医院神经外科,沈阳110032 [2]辽宁省抚顺市清原县人民医院神经外科

出　　处：《中华神经外科杂志》2009年第8期708-710,共3页Chinese Journal of Neurosurgery

基　　金：沈阳市科学技术计划（1081268-9-02）

摘　　要：目的探讨CT监测下硬通道技术治疗基底节脑出血的处理要点和疗效。方法在CT监测下行硬通道穿刺抽吸血肿、间断用尿激酶溶解引流残余凝血块方法，治疗68例基底节脑出血患者。临床评价标准包括术前与术后GCS评分、血肿体积减少量、平均手术时间、30d内死亡率。结果术前与术后GCS评分平均增加2．0分，血肿体积平均减少30％，平均手术时间23．6min，30d死亡率19．1％。结论CT监测下硬通道技术治疗基底节脑出血是一种简单、快捷、准确、安全、有效的手术方法，可能降低死亡率，但是必须强调适应证和时机。Objective To explore the treatment of basal ganglia hemorrhage by transcranial puncture. Methods Sixty eight patients of basal ganglia hematoma excluded Glasgow Coma Scale 〈 5 were treated by mini - invasive needle transcranial puncture in Computer Tomography room. A metal needle drilled by electric power through scalp and skull into intracerebral hematoma with local anesthesia on examination table guided by CT scan. The hematoma was aspirated through needle as rigid canal and drainage with urokinase within several days. The clinical evaluation included preoperative and postoperative GCS scores and hematoma volume. The mean puncture process times and 30 - day mortality rate were also considered. Results The mean postoperative GCS score was increased 2. 0 and the mean hematoma volume was reduced 30%. The mean puncture process time was 23.6 minutes and 30 - day mortality rate was 19. 1%. Conclusions Transcranial puncture is a simple, rapid, precise, safe and effective technique for the treatment of basal ganglia hemorrhage and could reduce mortality. However the indication and opportunity of puncture must be considered.

关 键 词：基底节脑出血 微侵袭 CT 

分 类 号：R686[医药卫生—骨科学]