自制双腔引流管穿刺引流术治疗高血压性脑出血  

Clinical efficacy of puncture and drainage with self-made double-lumen drainage catheter for patients with hypertensive intracerebral hemorrhage

作　　者：王建兵 黄喆[2] 张亚飞[1] WANG Jian-bing;HUANG Zhe;ZHANG Ya-fei(Department of Neurosurgery,Hanzhong People's Hospital,Hanzhong 723000,China;Department of Neurosurgery,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市人民医院神经外科,陕西723000 [2]汉中市中心医院神经外科,陕西723000

出　　处：《中国临床神经外科杂志》2024年第9期541-543,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨自制双腔引流管穿刺引流术治疗高血压性脑出血的疗效。方法回顾性分析2019年1月至2022年1月采用自制双腔引流管穿刺引流术治疗的52例高血压性脑出血的临床资料。结果基底节区出血26例,丘脑出血12例,脑叶出血8例,原发性脑室出血6例;出血破人脑室11例;出血量20~70 ml,平均(51±12)ml。术后3 d复查头部CT显示清除率在85%以上;术后再出血4例,颅内感染2例,死亡2例,放弃治疗3例。47例出院后随访6~12个月,日常生活能力分级Ⅰ级10例,Ⅱ级13例,Ⅲ级16例,Ⅳ级6例,Ⅴ级2例。结论自制双腔引流管穿刺引流术治疗高血压性脑出血,血肿引流充分,可防治再出血,术后堵管、逆行性感染风险低,疗效良好。Objective To explore the therapeutic effectiveness of puncture and drainage with self-made double-lumen drainage catheters for patients with hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 52 patients with HICH treated by puncture and drainage with self-made double-lumen drainage catheters from January 2019 to January 2022 were retrospectively analyzed.Results There were 26 cases of basal ganglia hemorrhage,12 cases of thalamic hemorrhage,8 cases of lobar hemorrhage,and 6 cases of primary intraventricular hemorrhage;11 cases had secondary hemorrhage into the ventricles;the hemorrhage volume ranged from 20 to 70 ml,with an average of(51±12)ml.Head CT reexamination 3 days after the operation showed that the clearance rate was above 85%.There were 4 cases of postoperative rebleeding,2 cases of intracranial infection,2 cases of death,and 3 cases of treatment abandonment.Forty-seven cases were followed up for 6~12 months after discharge.The classification of activities of daily living was gradeⅠin 10 cases,gradeⅡin 13 cases,gradeⅢin 16 cases,gradeⅣin 6 cases,and gradeⅤin 2 cases.Conclusion Puncture and drainage with self-made double-lumen drainage catheters for patients with HICH has sufficient hematoma drainage,can prevent rebleeding,has a low risk of postoperative tube blockage and retrograde infection,and has a good therapeutic effectiveness.

关 键 词：高血压性脑出血 穿刺引流术 自制双腔引流管 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]