微创穿刺术治疗自发性小脑出血20例

Application of microinvasive craniopuncture technique in treating 20 cases with spontaneous cerebellar hemorrhage

目的探讨YL-1型颅脑穿刺针穿刺治疗小脑出血的手术方法和治疗效果。方法采用国产YL-1型颅脑穿刺针,通过头颅CT显示的血肿最大平面定位,确定体表穿刺点和穿刺方向,穿刺成功后,利用血肿碎吸技术和尿激酶灌洗引流治疗小脑血肿20例。结果20例手术均获成功,无手术死亡病例。术后因肺部感染和肾功能衰竭死亡2例。术后3个月～6个月随访,按日常生活能力(ADL)评定:Ⅰ级3例,Ⅱ级4例,Ⅲ级8例,Ⅳ级2例,Ⅴ级1例。结论精确定位后,采用YL-1型颅脑穿刺针治疗小脑出血操作方便,不受年龄、重要器官功能限制,扩大了手术适应证,且疗效满意,适于在基层医院开展。

Objective To probe the curative effect of microinvasive craniopuncture with YL-1 puncture needle and technique in treating cerebellar hemorrhage.Methods Puncturing points were marked on the scalp in accordance with the maximal transverse section of cerebellar hematoma which was showed by CT scanning.20 cases with spontaneous cerebellar hemorrhage were treated with microinvasive craniopuncture and flushing with urokinase technique.Results 20 cases all were success and no operational death occurred in this group.2 cases died from severe pneumonic infection and renal failure.18 patients survived and were followed up 3 to 6 months after operation.Assesment with Activity of Daily Living（ADL） showed 3 cases of grade Ⅰ ,4 cases of grade Ⅱ,8 cases of grade Ⅲ ,2 cases of grade Ⅳ and 1 case of grade Ⅴ .Conclusion YL-1 puncture needle and its technique had the advantages of good convenience,more indications than craniotomy and satisfactory effects in treating cerebellar hemorrhage. [ Key Words ]