锥颅治疗脑内血肿:单孔引流与多孔引流的效果对比  

Comparison between the curative effects of drainages through one-point puncture and multi-point puncture on spontaneous intracerebral hemorrhage

作　　者：姚国杰[1] 龚杰[1] 徐国政[1] 李成才[1] 杜威[1] 韦可[1] 刘征[1] 黄成[1] 张戈[1] 马廉亭[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2012年第1期12-14,20,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的比较简易头皮下定位锥颅单孔引流与多孔引流治疗自发性脑内血肿的效果。方法回顾性分析55例自发性颅内血肿患者,头皮定位单孔引流31例[血肿量(52.9±13.2)ml],头皮定位多孔锥颅24例[血肿量(55.3±15.4)ml],术后给予尿激酶溶解血肿。比较引流时间、血肿残留量及日常生活能力Barthel指数。结果多孔引流组引流时间[(6.5±2.7)d]明显短于单孔引流组[(10.6±3.2)d](P<0.05);在治疗后3个月,多孔引流组的Barthel指数(71.87±7.53)明显高于单孔引流组(50.62±17.20)(P<0.05)。结论对于较大的且形状不规则的血肿应该在定位下实施多点穿刺。微创穿刺血肿腔引流加尿激酶冲洗简单易行,血肿清除率高,术后恢复好。Objective To observe the curative effect of drainage through multi-point puncture on the spontaneous intracerebral hematomas. Methods The clinical date of 55 patients with spontaneous supratentorial intracerebral hemorrhage, of whom, 31 were treated by drainage of the hematomas [the volume, （52.9±13.2）ml] through one-point puncture and 24 by the drainage of hematomas the [volume, （55.3±15.4）ml] through multi-point puncture were analyzed retrospectively. All the patients received fibrinolysis treatment with urokinase in both the groups. The curative effects were compared between both the groups. Results The duration of the drainage [（6.5± 2.7）days] was signi fi cantly shorter in the multi-point drainage groups than that [（10.6 ± 3.2）days] in the one-point puncture drainage group （ P 0.05）. Activities of daily living Barthel index （71.87±7.53） was significantly higher in the multi-point drainage group than that （50.62±17.20） in the one-point drainage group 3 months after the drainage （ P 0.05）. Conclusion The drainage of hematomas through multi-point puncture and fibrinolysis should be performed in the patients with irrigalar shape and large spontaneous intracerebral hematomas because it is easily performed and has good curative effect on the intracerebral hematomas.

关 键 词：脑出血 锥颅引流术 多点穿刺 微创手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]