超早期颅内血肿微创钻孔引流术治疗高血压基底节区脑出血

Ultra-early microsurgical treatment via trephination drainage of hematoma for hypertensive basal ganglia hemorrhage

目的总结超早期颅内血肿微创引流术治疗高血压基底区节脑出血的经验。方法对我院88例高血压基底节区脑出血患者在超早期采用颅内血肿微创钻孔引流术清除血肿。对其临床资料进行回顾分析。结果本组患者均于术后24h后复查头颅CT,其中血肿清除量>90%者21例,50%～70%者44例,<50%者23例,再出血4例。对患者进行6个月随访,按日常生活能力分级法(ADL)评测:Ⅰ级10例,占11.3%;Ⅱ级25例,占28.4%;Ⅲ级41例,占46.6%;Ⅳ级12例,占13.6%;Ⅴ级0例。效果良好率86.3%。结论超早期颅内血肿微创钻孔引流术治疗高血压基底节区脑出血,具有创伤小、解除血肿占位效应好、术后再出血率低、并发症和致残率低、功能恢复快等优点,值得推广应用。

Objective To summarize the clinical experience of Ultra-early microsurgical treatment via trephination drainage of hematoma for hypertensive basal ganglia hemorrhage.Methods To retrospectively analyze the clinical datas of 88 patients with hypertensive basal ganglia hemorrhage who were perfomed microsurgical treatment via trephination drainage of hematoma.Results Postoperative CT examination postoperation 24 hours showed that the patients＇ hematoma was evacuated over 90% in 21,and evacuated 50%～70% in 44,and evacuated less than 50% in 23.4 patients were rehemrrahage after operation.These patients were followed-up 6 months according to the Ability of Daily Live（ADL）.The recovery degree was Ⅰ in 10 patients（11.3.1%）,Ⅱ in 25（28.4%）,Ⅲ in 41（46.6%）,Ⅳ in 12（13.6%）,Ⅴin zero.ADL well recovery was 86.3%.Conclusion Ultra-early microsurgical treatment via trephination drainage of hematoma for hypertensive basal ganglia hemorrhage has advantages of micro-invasion,more complete hemorrhage evcuation,lower incidence of complications and disability,better recovery.It is suited to application.