早期微创锥颅治疗高血压脑出血110例临床研究  

Early-stage Minimally Invasive Aspiration for the Treatment of Hypertensive Cerebral Hemorrhage(HICH):110 Cases of Clinical Analysis

作　　者：裴本根 潘斯俭[2] 张健[1] 计跃[1] 蒋洪国 杨奎[1] 黄本生[1] 袁同方 

机构地区：[1]安徽省淮南朝阳医院神经外科,232000 [2]上海交通大学医学院附属瑞金医院神经外科,200025

出　　处：《中华全科医学》2011年第4期531-532,共2页Chinese Journal of General Practice

摘　　要：目的探讨在头颅CT引导定位下早期行软通道微创锥颅穿刺引流治疗高血压脑出血的临床疗效及安全性。方法 110例高血压脑出血患者经CT检查确诊后,早期在头颅CT引导定位,局麻下行软通道锥颅穿刺置管引流。术后给予尿激酶2万U加生理盐水5 ml分次注入血肿腔溶解血肿并持续引流。结果术后生存91例(82.7%),出院时根据日常生活活动能力(ADL)分级标准:Ⅰ级16例,Ⅱ级24例,Ⅲ级35例,Ⅳ级l2例,Ⅴ级4例。Ⅰ级、Ⅱ级、Ⅲ级为恢复优良,恢复优良率为68.18%(75/91)。死亡19例,病死率为17.3%。结论早期微创锥颅治疗高血压脑出血是一种有效、简便、可靠、安全的手术方法。Objective To evaluate the therapeutic efficacy and security of CT-guided minimally invasive soft skull channel drainage in the treatment of hypertensive cerebral hemorrhage. Methods The hypertensive cerebral hemorrhage patients that diagnosed by CT scan, and with the CT localization the soft channel intubation were performed under local anesthesia. Afterwards, 20 000 U urokinase were fractionally injected into the haematoma cavity with constant drainage to dissolve it. Results After the operation,91 cases survived（survival rate： 82.7% ） among which the activities of daily living（ADLs） grade were as follows： grade Ⅰ 16 cases,grade Ⅱ 24 cases,grade Ⅲ,35cases,grade Ⅳ 12 cases,grade Ⅴ 4 cases. 68.18% （75/91） patients were defined as remarkable recovery（ grade Ⅰ -gradeⅢ ）. Condusion The minimally invasive craniopuncture technique was safe and practical in the treatment of hypertensive cerebral hemorrhage.

关 键 词：高血压脑出血 早期 微创引流 

分 类 号：R743.34[医药卫生—神经病学与精神病学]