CT引导下颅内血肿穿刺引流的临床分析

目的探讨cT引导下颅内血肿穿刺引流的临床方法及治疗注意事项。方法采用YL-1型血肿穿刺针在CT引导下锥颅骨穿刺,置管引流实质内血肿,并联合应用尿激酶灌注溶液进行治疗。结果67例患者中32例脑出血明显好转,18例引流不畅,出血无明显变化,12例患者病情加重而改型开颅区骨瓣减压,开放引流或血肿清除术,5例患者病情危重死亡。出院后追踪随访1年,患者存活57例,死亡5例。术后6个月进行日常生活能力分级评分标准来评价,I级34例,Ⅱ级14例,Ⅲ6例,Ⅳ3例,Ⅴ级植物人生存或死亡5例。结论CT引导下颅内血肿穿刺引流,联合应用尿激酶溶解血肿,能有效治疗脑血肿,该治疗方法简捷,创伤小,副作用少,费用低廉,具有较高的安全性,能有效减低患者的病死率,提高患者的生存质量,值得在基层医院广泛推广应用。

Clinical Study and Analysis of CT- guided Intracranial Hematoma Paracentesis

Objective To investigate the clinical method, treatment and announcements of CT - guided intracranial hematoma para- centesis. Methods Y1 - lform hematoma paracentetic needle was used to conduct cone skull puncture intracranial hematoma with CT - guided and to drain intraparenchymal hematoma, and urokinase perfusion was used for treatment. Results 32 eases of 67 patients with cerebral hemorrhage improved obviously, 18 cases had poor drainage with no significant changes of hemon＇hage, 12 patient＇ condition ag- gravated so that opening skull surgery for decompression and hematoma evacuation were used, 5 cases died. Followed up for one year after discharge, 57 patients survived, 5 cases died. Six months after surgery, daily activity was evaluated with classification score： 34 cases in the 1st grade, 14 cases in the 2nd grade, 6 patients in the 3rd grade, 3 cases in the dth grade and 5 eases in the 5th grade （becoming a vegetable or dead）. Conclusion CT - guided intracranial hematoma paracentesis associated with urokinase perfusion is effective in cere- bral hemorrhage treatment, with the advantages of simple and little damage, less side effect, low cost and high security, which can de- crease the fatality rate, improve the quality of life and should be widespread extended in basic level hospital.