CT监视下YL-1型一次性使用颅内血肿粉碎穿刺针穿刺治疗高血压性脑出血80例临床分析  

Clinical analysis of 80 cases with hypertensive intracerebral hemorrhage treated by intracranial hemorrhage smash puncture needle with YL-1 type disposable under CT monitoring

作　　者：赵宪林[1] 姜宏舟[1] 刘国军[1] 王庭忠[1] 

机构地区：[1]中国医科大学附属第四医院神经外科,沈阳110032

出　　处：《中国医师进修杂志》2012年第11期14-16,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨CT监视下YL-1型一次性使用颅内血肿粉碎穿刺针穿刺治疗高血压性脑出血的临床价值和疗效。方法选择80例高血压性脑出血患者，在CT监视下应用YL-1型一次性使用颅内血肿粉碎穿刺针穿刺引流血肿，间断用尿激酶冲洗并引流出残留血凝块。观察血肿体积减少量、手术时间、术前与术后格拉斯哥昏迷量表（GCS）评分、临床疗效及远期随访。结果手术时间15-45（25．0±2．8）min；术后血肿体积减少率30％-80％（56．8±3．2）％；GCS评分增加（2．3±0．3）分。随访2-24个月，80例患者死亡10例，70例幸存者进行日常生活能力（ADL）评估：ADL1级17例（24．3％），ADL2级36例（51．4％），ADL3级13例（18．6％），ADL4级3例（4．3％），ADL5级1例（1．4％）。结论CT监视下YL-1型一次性使用颅内血肿粉碎穿刺针穿刺治疗高血压性脑出血是一种简单快捷、定位准确、不用开颅和输血、安全有效的手术方式，但要注意手术适应证。Objective To study the clinical value and efficacy of intracranial hemorrhage smash puncture needle with YL-1 type disposable under CT monitoring in treatment of hypertensive intracerebral hemorrhage. Methods The data of 80 cases with hypertensive intracerebral hemorrhage patients who accepted the transcranial puncture under CT monitoring application of YL-1 type disposable intracranial hemorrhage smash puncture needle and drainage of hemorrhage,punctuated with urokinase washout and drainaged residual blood clot. Evaluation criteria：hemorrhage volume reduction,average operation time, preoperative and postoperative Glasgow coma scale （GCS） score, the clinical effect of long-term follow-up. Results Operation time was 15-45 （ 25.0 ±2.8 ） minutes; hemorrhage volume was reduced by an average of 30%-80% （56.8 ± 3.2）% ,the average increase of GCS was （2.3±0.3） scores,10 cases death in 80 patients,70 survivors＇ activities of daily living （ADL） assessments：grade ADL 1 in 17 eases （24.3%） ,grade ADL2 in 36 cases（51.4%）, grade ADL3 in 13 cases （18.6%）,grade ADL4 in 3 cases（4.3%）,grade ADL5 in 1 ease （ 1.4% ）. Conclusions YL-1 type disposable intraeranial hemorrhage smash puncture needle under CT monitoring in the treatment of hypertensive intracerebral hemorrhage is a simple, fast and accurate positioning, without craniotomy and blood transfusion, safe and effective operation, but should pay attention to operation indications.

关 键 词：颅内出血 高血压性 穿刺术 硬通道 

分 类 号：R651.1[医药卫生—外科学]