200例微创清除颅内血肿（嗽肿、积液）临床应用分析

目的 介绍200例微创清除颅内血肿（脓肿、积液）外科治疗经验体会。方法 采用YL-1型一次性颅内血肿特制穿刺针，对〉60ml的脑内血肿全部采用双针穿刺引流、对口引流，配合生物溶酶技术清除血肿，配合腰椎穿刺置管引流。结果 高血压脑出血血肿〈60ml死亡率为2．1％，〉60～80ml约8．2％，其余死亡率为0。结论 （1）特重型脑出血双靶点微创手术治疗，配合腰椎穿刺置管引流是提高颅内巨大血肿清除率，降低死亡率及致残率的重要方法；（2）自发脑出血超早期微创清除血肿损伤小，疗效好，定位准确，恰当并及时应用血肿液化剂，防治再出血，预防和及时治疗并发症等是影响预后的关键；（3）微创更广泛的应用于外伤脑出血、脑脓肿、硬膜下积液、慢性硬膜下出血等神经外科领域。

Objective Introduce the infinitesimal trauma to a potential marriage partner that get rid of cerebral hemorrhage or abscess to 200 cases Methods Made use of YL-1 that crushing cerebral hemorrhage of the punctured needle head to use once. All that use two it to crushing cerebral hemorrhage of overstep sixty milliliter. The couple drainage tube to crushing cerebra hemorrhage and pour into the living things technology of the hemolytic. At the same time the lumbar vertebra be punctured and found a place for drainage tube to continued drainage the blood CSF（cerebrospinal fluid）. Results The death rate is 8.2%that capacity for the dermatomes is exceed sixty milliliter and the death rate is 0 % for the others. Conclusion （ 1 ） It is important way to raise the dermatomes and lover the death rate and the incur maimed rate that use YL-1 crushing cerebral hemorrhage the punctured needle head forthe most dermatomes; （2） It is the most crux to affect prognosis that exceed early stage dermatomes to minute trauma operation of accurate orientate. Proper and in time use dermatomes liquidate and prevention and cure the dermatomes again and complication seasonable; （3） The minute trauma is putted more extensive to use that cerebral hemorrhage hydrocephalus brain abscess It is important way to raise the dermatomes and lover the death rate and the incur maimed rate that use YL- 1 crushing cerebral hemorrhage the punctured needle head for the most dermatomes.