摘要
目的探讨双软通道置管抽吸并尿激酶治疗脑血压脑出血的手术方法及临床疗效。方法对56例高血压脑出血患者、在CT引导下采用方体定向原理、钻颅穿刺、双软通道抽吸血肿、尿激酶溶解残余血肿进行回顾性分析。结果术后头颅CT复查,血肿体积平均减少91.2%,平均住院时间12d,近期采用格拉斯哥预后量表(GOS)5个标准:优15例,良19例,重度残疾11例,植物生存6,死亡5例,死亡率8.9%;对存活51例随访2～6个月,死亡3例(其中1例为术前GCS评分5分以下),远期采用日常生活能力(ADL)分级法进行评估:ADLⅠ10例(20.8%),ADLⅡ21例(43.8%),ADLⅢ8例(16.7%),ADLⅣ6例(12.5%),ADLⅤ3例(6.3%),ADLⅢ以上10例(18.7%)。结论双软通道置管抽吸并尿激酶治疗高血压脑出血是一种创伤小、定位准确、操作简便、费用低廉的手术模式,适宜基层医院推广,提高患者的生存率,减少并发症及后遗症。
Objective To analyze the operation method and clinical efficacy of bi - soft tube indwelling as- piration and Urinekinase for hypertensive interacerebral hemorrhage. Methods Fifty - six cases of hypertensive inter- acerebral hemorrhage who underwent bi - soft tube indwelling aspiration and Urinekinase were retrospectively re- viewed. The main operation procedures, guided by CT and abided by stereotactic principle, include bi - soft - tube hematoma aspiration, skull - drilling and puncture, and lysis of remainder hematoma with Urinekinase. Results Af- ter - operation CT reviews of skull displayed that hematoma volume averagely declines 91.2 %, and the average time of hospitality remained 12 days ; and five standards of GOS were adopted to show the short - term effects ： 15 cases in well condition, 11 cases recovery, 11 cases severely disabled, 4 cases vegetable, 5 cases dead, death rate 8.9%. The 2 -6 months＇ follow- up of the 51 surviving cases showed 3 cases dead（ the pre -operational GCS evaluation of one case was below 5 ）, and ADL gradation was utilized to evaluate the long - term effects ： ADL - I （20.8%） 10 ca- ses, ADL - II （43.8%） 21 cases, ADL -III （ 16.7% ） 8 cases, ADL - IV （ 12.5% ） 6 cases, ADL - V （6.3%） 3 cases, ADL- V and higher level （18.7%） 10 cases. Conclusion The bi - soft tube aspiration and Urinckinase for hypertensive interacerebral hemorrhage is an operational method with little trauma, stereotactic accuracy, conven- ient procedures and low prices, suitable for the grass root hospitals, and its use and spread will elevate the survival rate and reduce the complication and sequelae.
出处
《现代医院》
2013年第4期34-37,共4页
Modern Hospitals
关键词
高血压脑出血
方体定向
抽吸
尿激酶
引流术
Hypertensive interacerebral hemorrhage
Cuboid stereotactic
Aspiration
Urinekinase
Drainage
