高血压丘脑出血的超早期手术治疗

Operation therapy to the superearly stage of the thalamus hemorrhage in hypertension disease

目的 :评价微创血肿碎吸、尿激酶溶解引流超早期治疗高血压丘脑出血的效果。方法 :依据CT摄片定位 ,采用YL 1型一次性使用颅内血肿粉碎穿刺针钻颅血肿碎吸、尿激酶溶解引流超早期治疗高血压丘脑出血 2 6例。结果 :本组 2 6例 ,术后第 3天复查头颅CT ,血肿大部分消失 ;术后第 5天复查CT ,血肿基本消失。手术后近期疗效 :住院期间死亡 6例 ,死亡率为2 3% ,放弃治疗 2例。生存的 18例病例中 ,以日常生活能力分级法 :ADLⅠ级～Ⅲ级 15例 ,占 83%。结论 :应用微创血肿碎吸、尿激酶溶解引流超早期治疗高血压丘脑出血具有损伤轻微 ,操作简便 ,手术时间短 ,术中出血少 ,不易感染 ,安全有效的特点 ,它弥补了开颅手术和保守治疗的不足 ,是降低死亡率及致残率 。

Objective To assess the efficacy of applying the microtrauma technique to absorb the broken hematoma,dissolving and draining with urokinase to treat the patients who suffered superearly stage thalamus hemorrhage in hypertension disease.Method 26 patients with supperearly stage thalamus hemorrhage in hypertension disease were treated with single use perforating needle (type YL 1) to drill the skull and absorb the broken hematoma,dissolving and draining with urokinase,according to the position made by CT.Results The bulk of hematoma disappeared in 22 cases after 3 days and almost nothing after 5 days.The recent developments after operation:6 patients died during hospitalized stage,The mortality is 23%. 2 cases of them were given up treatment.Among the 18 patients who survived after operation,15 cases belong to activities of daily living (ADL) Ⅰ to Ⅲ degree,classified with ADL(83%).Conclusion Applying microtrauma technique to absorb the broken hematoma,dissolving and draining with urokinase to treat the patients who suffered suppereaely stage thalamus hemorrhage in hypertension disease has a lot of advantages,including slight injury,simple and convenient operation,short time,little hemorrhage,hard infection,more safety and efficency.It overcomes the disadvantages of skull incision and conservative treatments.It is an effective method of decreasing the mortality and the incidence of becoming disabled,and improving the patients' living quality.