CT引导下立体定向引流治疗高血压基底节出血53例临床分析  

Clinical analysis of 53 cases with hypertensive basal ganglia hematoma of treated by CT-guided stereotactic drainage

作　　者：薛峰[1] 庄进学[1] 陈登奎[1] 陶传元[1] 郑小强[1] 宋朝理[1] 

机构地区：[1]解放军第452医院神经外科,成都610021

出　　处：《立体定向和功能性神经外科杂志》2012年第1期45-47,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨CT引导立体定向血肿穿刺引流术治疗高血压基底节出血的临床疗效及总结治疗经验。方法使用MD-2000A1型脑立体定向仪在西门子CT引导下,对我科2008年6月至2011年6月收治的53例中等量基底节出血患者行血肿穿刺引流术,术后辅以尿激酶溶解血凝块;依据ADL分级判断疗效。结果全组53例患者预后良好,无死亡,出院时能下床走路31例,坐轮椅15例,卧床7例。随访4～12个月,ADL分级Ⅰ级19例,Ⅱ级17例,Ⅲ11例,Ⅳ6例。结论 CT引导立体定向治疗高血压基底节出血是一种安全、微侵袭、临床疗效确切的手术方式,成功的关键在于适合病例的选择、穿刺靶位的定位、术后再出血的预防及尿激酶的合理应用。Objective To explore therapeutic effects of hypertensive basal ganglia hematoma treated by CT-guided stereotactic drainage and summarize related experiences.Methods 53 patients underwent CT-guided stereotactic aspiration and drainage followed by thrombolysis using urokinase between June 2008 and June 2011.Theraputic effects were judged according to Activity of Daily Life system.Results All patients gained good recovery without death.When discharge,31 cases can walk alone,15 cases can sit and the rest can only lie on bed.During 4 to 12 months follow up,19 cases,17 cases,11 cases and 6 cases belonged to Grade I,Grade II,Grade III and Grade IV of ADL grading system,respectively.Conclusion CT-guided stereotactic drainage for hypertensive basal ganglia hematoma is safe,mini-invasive whose therapeutic effect is definite.The key points include proper patients＇ selection,precise location on target for puncture,rebleeding prevention and suitable use of urokinase.

关 键 词：立体定向 高血压 脑出血 基底节 中等量 尿激酶 

分 类 号：R743.34[医药卫生—神经病学与精神病学]