探讨超早期微创术治疗高血压脑出血  

Ultra -early Minimally Invasive Treatment of Hypertensive Intracerebral Hemorrhage

作　　者：张春城[1] 李忠亮[1] 董毓卿 

机构地区：[1]吉林省九台市人民医院神经外科,吉林长春130500

出　　处：《中外医疗》2012年第33期8-9,共2页China & Foreign Medical Treatment

摘　　要：目的探讨超早期微创术治疗高血压脑出血的临床疗效。方法应用YL-1型一次性使用颅内血肿穿刺针,依CT片及CT下定位,以血肿最多最大层面选择穿刺点及穿刺针长度,针钻一体化在电钻驱动下一次快速钻透颅骨及硬脑膜后退出钻头,插入塑料针芯将穿刺针缓慢进入血肿中心,通过抽吸、冲洗、击碎、溶解、分离、引流达到清除血肿的目的。复查CT见血肿基本清除后再拔针。结果该组66例,死亡12例,死亡率18.18%,ADLⅠ级13例,ADLⅡ级25例,ADLⅢ级10例,ADLⅣ级5例,ADLⅤ级1例。结论微创术治疗伴有功能障碍的25～40 mL小血肿临床疗效优于传统内科保守治疗及外科开颅手术。超早期微创手术可使一部分病人不失时机得到抢救,打破危及生命的恶性循环,降低了死亡率、致残率,提高了生存质量。Objective To explore the clinical efficacy of Ultra-early minimally invasive treatment of hypertensive intracerebral hemorrhage.Methods Apply YL-1 single-use type of intracranial hematoma puncture needle,the patent of Beijing Wantefu Medical Devices Co.Ltd.in the surgery.According to the CT scan and CT,we can fix the puncturing position.Then choose the needle length and the puncturing point in accandance with maximum hematoma level.After that the pin driven by the drillpin puncture through the skull and dura fast and then the the drill exit.Insert the plastic needle slowly into the hematoma center,through suctioning,washing,crushing,dissolving,separating and drainaging,we can achieve the purpose of removing the hematoma.After review of the CT we remove the needle if the hematoma has been basically cleaned.Results Among the group of 66 cases,12 patients died,and the mortality rate is 18.18% with ADLⅠgrade 13 cases,ADLⅡgrade 25 cases,ADLⅢ 10 cases,ADLⅣ 5 cases,and ADLⅤgrade 1 case.Conclusion Clinical efficacy of minimally invasive treatment in Ultra-early minimally invasive treatment can rescue part of the patients pdysfunction associated with the 25 ～ 40 ml small hematoma is superior to the traditional conservative treatment and surgical craniotomy.romptly,break the life-threatening vicious circle,reduce mortality and improve quality of life survive.

关 键 词：高血压脑出血 超早期 微创术 

分 类 号：R651.1[医药卫生—外科学]