软通道微创引流高血压脑出血的临床研究

The clinical study on the treatment of hypertensive intracerebral hemorrhage by minimally invasive surgery

目的研究应用微创液化引流术治疗高血压脑出血的疗效。方法对243例高血压脑出血患者,根据CT检查结果,依据血肿的形态、位置、大小并结合患者的病情,选择适宜的穿刺点、方向,将软通道引流管顺利置入到血肿区域进行液化引流,清除血肿。结果 243例患者出院210例,死亡33例,病死率为13.6%;对出院的156例患者随访半年,以ADL评估神经功能,ADL1为78例(50%),ADL2为41例(26.3%),ADL3为24例(15.4%),ADL4为8例(5%),ADL5为5例(3%)。结论应用软通道微创液化引流术治疗高血压性脑出血,能最大限度地清除血肿,避免或减轻并发症,具有较大的优越性。

Objective To evaluate the effectiveness of minimally invasive therapy in treating hypertensive intracerebral hemorrhage.Methods CT was performed to show the form and position and volume of hypertensive intracerebral hemorrhage before the surgery,and to determine the suitable point and direction of puncture.The hematoma was eliminated by minimally invasive aspiration and drainage which was guided under CT image.Results 243 cases were received the minimally invasive therapy,210 cases were discharged and 33 cases died（mortality rate 13.6%）.Follow-up study of 156 cases was done ranging for 6 months after surgery,showed that 78 cases（50%）,41 cases（26.3%）,24 cases（15.4%）,8 cases（5%）,5 cases（3%） were classified into Barthel index of activities of daily life（ADL）1～5 respectively.Conclusion Minimal invasive therapy by a soft way of hypertensive intracerebral hemorrhage has great superiority,such as it can elimination most part of the hematoma,and avoiding or decreasing complications.