颅内血肿的CT导向介入治疗

目的探讨颅内血肿的CT定位介入治疗价值。方法我院2000~2003年间出血量在30~100 m l(平均50 m l)的颅内血肿患者共108例(其中高血压性脑出血位于壳核区58例、皮质下区6例、丘脑4例、小脑4例,外伤性硬膜下血肿24例、硬膜外血肿12例),行CT导向介入治疗。改良法穿刺层面的床距均为最大血肿层面床距加上层厚的一半,以穿刺针穿入端距离最大血肿中心≤1 mm视为CT导向穿刺成功,把挽救患者生命并改善生活质量作为临床治疗有效的标准。结果CT导向穿刺成功率99.8%。位于壳核、皮层下、丘脑区的高血压性脑出血治疗有效率94.3%,30 m l以上小脑高血压性脑出血CT介入治疗有效率为0,外伤性硬膜下和硬膜外血肿治愈率为97.2%。结论CT导向定位清除颅内血肿,除小脑血肿外效果好。

CT Guided Interventional Treatment of Intracranial Hematoma

Objective To investigate the value of CT guided interventional treatment in intracranial hematoma.Methods There were 108 cases with intracranial hematoma(30~100 ml,average of 50 ml) in our hospital from 2000~2003.Among them,58 cases were located in putamen,6 cases in subcortial,4 cases in thalamus,4 cases in cerebella,12 cases were traumatic eprdural hematoma and 12 cases were subdural hematoma.The table distance of the aspirated slice was the sum of table distance at the slice of the maximum hematoma and half slice thickness.It was considered successful for CT guided aspiration if the distance between the front of aspiration needle and the center ofthe biggest hematoma was not more than 1mm and it was regarded effective,when the patients' lives were saved and their life quality was improved.Results The success rate of CT guided aspiration was 99.8%.The effective rate of hypertensive intracerebralhemorrhage located in putamen,subcortial and thalamus was 94.3%.The effective rate of CT guided interventional treatment for cerebellar hypertensive intracerebral hemorrhage above 30ml was 0,the cure rate of traumatic epidural and subdural hematoma was 97.2%.Conclusion The effect of CT guided interventional treatment of intracranial hematoma is well except for cerebellar hematoma.