CT导向介入治疗高血压脑出血的探讨

CT guided interventional therapy for hypertensive cerebral hemorrhage

目的探讨高血压脑出血CT导向下穿刺液化引流术治疗高血压性脑出血的疗效。方法对40例高血压性脑出血患者,在CT引导下,依据血肿的形态、大小及患者的病情,选择适宜的穿刺点、方向,行CT单面引导下的微创穿刺液化引流术清除血肿。结果治疗组病死率12.5%(5/40),明显低于对照组45%(13/30)P<0.01。对出院患者随访6个月,以日常生活活动量表(ADL)评估患者神经功能,治疗组38例中ADL1～ADL3者27例(70%),明显高于对照组29.4%(5/17)P<0.05。结论应用介入穿刺液化引流术治疗高血压性脑出血,方法简便、定位准确、费用低、创伤小、安全有效,可较彻底清除血肿,值得临床推广。

Objeetive To discuss the curative effect of CT-guided puncture and drainage in treating hypertensive cerebral hemorrhale. Methods Adjusting the suitable point and direction of puncture according to the form and size of the haematoma and patient＇s status, the haematoma was eliminated by minimally invasive puncture and drainage guided under CT layer image in 40 cases of hypertensive cerebral hemorrhage. Results Modality rate of treatment group was 12.5% （5/40）, and is much lower than control group, which was 45% （13/30）.（P〈0.01）. When asscess the Activities of Daily Living （ADL） after 6 months follow-up, the ADL1-ADL3 scale in treatment group was 27 cases （70%）, and was much higher than that in control group, which was 29.4% （5/17）, （P〈 0.05）. Condusion Minimal invasive therapy of cerebral hemorrhage has great superiority in elimination most part of the hematoma such as simple, accurate location, low cost, safe and effective, and is worthy of recommendation clinically.