立体定向置管引流治疗重症高血压脑干出血

Treatment of Severe Hypertensive Brainstem Hemorrhage with Stereotactic Aspiration and Placed the Tube to Drainage

目的:探索重症高血压脑干出血的有效治疗方法。方法:采用立体定向置管引流治疗重症高血压脑干出血8例,其中男5例,女3例;中脑出血2例,桥脑出血4例,中脑、桥脑出血2例;出血量8.5～19.7ml,平均14.7ml;意识状况(按Glasgow计分法),3～5分4例,6～8分4例。抽吸后通过引流管分次注入尿激酶持续引流,血肿大部清除拔除引流管。结果:术后20～72小时内拔除引流管,血肿清除85％～90％。随访2～25月,8例全部存活。结论:立体定向置管引流治疗重症高压脑干出血,术中再出血并发症少,血肿清除时间短,有利于脑干功能的恢复,是重症高血压脑干出血的有效治疗方法。

Objective: To explore the effective method to treat severe hypertensive brainstem hemorrhage. Methods: Stereotac-tic aspiration and placed the tube to drainage was used in 8 cases with sever hypertensive brainstem hemorrhage, males 5 and female 3, Midbrain 2,pontine 4, both midbrain and pontine 2; The volume of hemorrhage 8.5 - 19.7ml(average 14.7ml);Glasgow scale in 3 - 5 scale and 6 - 8scale 4 cases respectively. Urokinase was injected into the hematoma after aspiration and infused the olot through tube and drainage. When the hematoma was evaluated, pulling out the tube. Results: The tube was pulled out 20 - 72 hours postopera-tion, 85% - 90% hemorrhage was evacuated. With 2-25 months follow - up, 8 survived. Conclusion: The method of treatment to severe hypertensive brainstem hemonhage with stereotactie aspiration and placed the tube to drainage was feasible and effective.