摘要
采用脑内血肿排空器及颅骨钮技术.以 CT片为依据免架测量定位行高血压性脑内血肿排空治疗Ⅲ例共112次;壳核区83例.丘脑4例.皮质下20例.小脑2例.胼胝体膝、纵裂各1例: 体积21～50ml 51例51～100 ml 42例.101～150 ml12例.>150ml 4例.以上共有27例同时破入脑室;2例小脑血肿<20ml.排空率>81%者73次、61%～80%者29次,51%～60%者10次: 手术病死率按病情统计.Ⅲ级为3%.Ⅳ级为12. 5%.Ⅴ级为69;Ⅲ、Ⅳ级合计为9.2%.Ⅲ、Ⅳ、Ⅴ级合计为16.2% 病死率按手术与发病时间分别统计为6h内含者62.5%.7～12h者25%.13～24h者10%.2～3d者11.6%.4～14d者11%.76例术后随访2～6O个月.2例呈植物状态.17例因其它原因死亡,57例恢复良好.
One hundrad and eleven cases (112times) of hypertensive intracerebral hematomasevacuation were performed by a newly designedevacuator through a small skull button hole un-der the localization of frameless measuring fromCT film. The hematomas were located over theputamen nucleus region in 83 cases , thalamus in4 cases, subcortical in 20 cases, cerebellum in 2cases and knee portion of corpus callosum andlongitudinal fissure 1 case respectively. The vol-ume of hematoma was 21~50 ml in 51 cases,51~100 ml in 42 cases, 101 ~ 150 ml in 12 casesand more than 150 ml in 4 cases. Among thesecases there were 27 cases in which thehematomas extended into the ventricles. The vol-ume was less than 20 ml in 2 cases of cerebellarhematomas. Evacuation rate of the hematomasmore than 81% in 73 cases , 61%-80% in 29cases and 51%~60% in 10 cases. The operativemortality statistics according to the patient'sconditions were: grade III at 3%,grade IV at 12. 5% and grade V at 69%,associate grade III andIV was 9.2%,grade III , IV and V was 16. 2%.The operative mortality statistics according tothe period from stroke to operation were less 6hours at 62. 5%, 7-12 hours at 25%,13-24hours at 10%,2-3 days at 11.6% and at 11%on 4-14 days. A follow-up of 76 cases from 2 to60 months after operation showed that 2 patientsretained in vegetative state, 17 patients died fromother reasons and 57 patients recovered in a goodcondition.
