多参数定位在高血压性脑出血定向置管术中的应用

Application of stereotatic puncture and drainage under multiparameter orientation in the treatment of hypertensive intracerebral hemorrhage

目的探讨多参数定位立体定向血肿腔内置管治疗高血压性脑出血的疗效及适应证。方法2003年10月-2005年5月，我院对56例高血压性脑出血采用立体定向技术，对人颅点、穿刺平面、穿刺角度、深度、引流管侧孔长度进行精确设定。必要时选择一孔多点置管。结果根据GOS评分，恢复良好12例（21．4％），中残29例（51．8％），重残12例（21．4％），死亡3例（5．4％）。结论多参数定位立体定向血肿腔内置管治疗高血压性脑出血，定位准确，创伤小，疗效显著。10—60ml血肿均可进行该手术，尤其适用于年老体弱及深部血肿患者。手术时机以发病3—6h为宜。

Objective To explore therapeutic effects and indications of stereotatic puncture and drainage under multiparameter orientation in the treatment of hypertensive intracerebral hemorrhage （ HICH）. Methods A total of 56 patients with HICH underwent stereotatic puncture and drainage from October 2003 to May 2005. The entrance position, the puncture plane, the puncture angle and depth, and the length of side hole of drainage tube were accurately designed before operation, and, if necessary, multiple drainage tubes were introduced via one hole. Results According to the Glasgow Outcome Scale （GOS） scores, 12 patients recovered well （21.4%）, 29 patients were moderate disability （51.8%）, and 12 patients were severe disability （21.4%）, No longstanding coma was noted. Three patients died （5.4%）. Conclusions Stereotatic puncture and drainage under multi-parameter orientation has better therapeutic effects and less damages than open operation. The procedure is suitable for 10 - 60 ml hematoma, especially in elderly patients and deep-located hematoma. The best operation timing is 3 - 6 hours after the onset of hemorrhage.