微创置管吸引术救治高血压脑出血

Aspiration of hypertensive intracerebral hematoma by minimally invasive tube insertion

目的初步探讨应用微创置管吸引术救治高血压脑出血的临床效果及意义。方法根据患者术前CT或CT片上提供的颅脑立体定位数据,采用微创定向颅内置管装置医疗器械,治疗高血压脑出血患者72例。所有病例术中经单或多靶点径路微创软管脑内血肿抽吸和术后残血尿激酶溶凝引流的方式及对血肿破入脑室积血患者配合腰穿置换治疗。结果血肿腔内置管准确率100%。术中血肿清除率和术后残血清除留管时间均值:单靶点径路32.2%和6.5d,多靶点径路为56.5%和4.5d,两方法比较有显著意义。结论微创定向脑内血肿置软管吸引术治疗高血压脑出血是一种定位准确,方法简易,适宜抢救,创伤微小,疗效确切,易于推广的新技术。

Objective To investigate the clinical results and significance of aspirating hypertensive intracerebral hematoma by a sofe tube inserted by minial invasive technigue. Methods According to the stereotactic data of CT or CT-film in preoperative patients, 72 cases with hypertensive intracerebral hematoma were treated by the apparatus. All patients were treated by the aspiration of a minimal-trauma soft-tube by a single or more target approaches and the tube was left as drainage in place for further administration of unokinase and aspiration of the residual dissolved hematoma. Lumbar punctures for the replacement fluid with blood were also done with intraventricular hematomas. Results The accuracy of installing tubes into the cavity of hematomas was 100%. 32.2% of volume of the hematoma was evacuated during operations and the drainaging time was 6.5 days in a single target approach,56.5% hematoma was evacuated and 4.5 days drainage was in the more target approaches in average. The results of two approaches were compared significantly. Conclusion The aspiration of hypertensive intracerebral hematoma by minimal-trauma stereotactic installed soft tube in the hematoma is a new technique, which has been proved to be accurate, effective, simple, and with minimal trauma to the patient.