微骨孔人路神经内镜下超早期治疗脑出血疗效研究

目的探讨超早期微骨孔人路神经内镜下手术辅以灌注尿激酶引流血肿治疗脑出血的疗效。方法26例患者在内窥镜下穿刺血肿手术，以CT评估血肿残留量，随访6个月，以GOS评估预后。结果术后复查CT血肿清除率：第1天：〈30％3例，30％～50％12例，50％～70％9例，〉70％2例；第3天：〈30％0例，30％～50％2例，50％～70％5例，〉70％19例。随访6个月GOS评估，良好18例，一般6例，较差2例，死亡1例。结论超早期微骨孔人路神经内窥镜下血肿清除辅以灌注尿激酶引流治疗高血压脑出血，具有精确性、直视性、微创性、简便性，血肿清除率高，致残率低及预后良好等优点。

Study on ultra early treatment for cerebral hemorrhage via keyhole approach underendoscope

Objective 30 study the effect of ultra early keyhole approach endoscopic operation with urokinase perfusion drainage of hematoma in treatment of cerebral hemorrhage. Methlds 26 patients underwent endoscopic puncture hematoma operation, and residual hematoma volume were evaluated by CT with eht follow-up of 6 months and GOS prognostic evaluation. Result Postoperative CT hematoma clearance rate was 3 cases 〈 30% ,30% -50% 12 cases,50% -70% 9 cases, 〉70% 2 cases in first day and 〈 30% 0 case,30% -50% 2 cases,50% -70% 5 cases, 〉70% 19 cases in the third day. GOS evaluation of the follow-up about 6 months showed good in 18 cases ,general in 6 , poor in 2 and death in 1 . Conclusion Super early keyhole approach endoscopic puncture operation to remove the hematoma with urokinase perfusion drainage in the treatment of hypertensive intracerebral hemorrhage （ HICH ）, has accuracy, direct vision, minimally invasive, simplicity, and higher hematoma clearance rate, disability rate is low and the prognosis is good.