软通道微创手术治疗高血压性脑出血56例临床分析

Application of soft channel puncture hematoma evacuation on the treatment of 56 cases of hypertensive cerebral hemorrhage

目的探讨应用软通道穿刺血肿引流术治疗56例高血压脑出血患者的经验体会。方法对56例患者根据脑出血后意识状况,分级在Ⅱ～Ⅳ级,出血量>30ml,出血部位深在的高血压脑出血患者,选择不同时机进行软通道穿刺,抽吸部分血肿,术后辅助于尿激酶灌注,进行血肿腔引流。结果高血压脑出血56例患者,术后CT复查均提示血肿排空满意,局部脑结构恢复良好。大部分预后良好,其中ADL分级法Ⅰ级15例(26.8%),Ⅱ级20(35.7%),Ⅲ级11例(19.6%),Ⅳ级4例(7.1%),Ⅴ级6例(10.7%)。结论软通道微创穿刺引流术治疗高血压脑出血,手术操作简便,反应轻,手术效果好,术后康复快,值得推广。

Objective To investigate the efficacy of soft channel puncture hematoma evacuation on the treatment of 56 cases of hypertensive intracerebral hemorrhage patients. Methods 56 cases of cerebral hemorrhage patients was collectd, which with consciousness grade at II IV, bleeding volume exceed 30ml and located deeply. The soft channel puncture was carryed out at different time according to the patients＂ conditon. Part of the hematoma was aspirated and then assisted with perfusion of urokinase postoperation. Results Postoperative CT shows that hematoma emptying was favourable in all the 56 cases and brain structure recovery was well. Most patients were with good prognosis, according to the ADL classification method, grade I （15 cases, 26.8%）, grade II（20 cases, 35.7%）, grade III（11 cases, 19.6%）,grade IV（4 cases, 7. 1%）, and 6 cases in grade V （ 10. 7%）. Conclusion The soft channel puncture hematoma evacuation was easier operating, less injury, faster recovery in the treatment of hypertensive intracerebral hemorrhage patients. The soft channel of minimally invasive operation in treatment of hyperten- sive cerebral hemorrhage operation, simple operation, mild reaction, good operation effect, faster postoperative recovery, is worth popularizing.