螺旋CT监视下微创血肿引流术治疗高血压脑出血的临床应用

目的探讨应用螺旋CT监视下微创血肿引流术治疗HICH的疗效。方法分析45例采用CT监视下微创血肿引流术治疗的HICH患者临床病历资料,并对出院患者继续随访1～6个月,观察出院患者生存状况和神经功能恢复情况。结果45例患者采用螺旋CT监视下微创颅脑血肿清除术,术中CT扫描穿刺针尖均位于血肿内,术后8h对患者进行CGS评分,平均增加2．3分,拔针后复查血肿清除率平均为78-2％,其中29例血肿完全清除,术后死亡1例;对出院的44例患者继续随访1—6个月,ADLI级和Ⅱ级共8例,Ⅲ级22例,Ⅳ级12例,V级1例,死亡1例,死亡原因为并发心肌梗死。结论螺旋CT监视下微创血肿引流术治疗HICH创伤小,手术时间短,操作简单,有在基层医院推广应用的价值。

Clinical application of spiral CT-guided micro-invasive surgery in the treatment of hypertensive intracerebral hemorrhage

Objective To investigate the effect of spiral CT-guided micro-invasive surgery in the treatment of hyper- tensive intracerebral hemorrhage （HICH）. Methods The clinical dates of 45 cases with HICH done CT-guided miero- invasive surgery were analyzed. The living condition and improvement of nervous function of discharged patients were observed in the follow-up visit in 1-6 months. Results The 45 cases with HICH were done CT-guided micro-invasive surgery and the puncture needles were all in the hematoma by CT scan in the surgery. The CGS increased 2.3 on the average after 8 hours of surgery. The clearance rate of hematoma after withdrawal of puncture needles was 78.2% on the average, 29 eases of them were eliminated totally and 1 case died after the surgery. 44 eases were follow-up visit- ed in 1-6 months, 8 cases of them with the ADL I grade and II grade, 22 cases with the ADL III grade, 12 cases with the ADL IV grade, 1 case with the ADL V grade, and 1 case died of the complication of myocardial infarction. Con- clusion The spiral CT-guided micro-invasive surgery in the treatment of HICH has slight trauma, short surgery time and simple operation, which is worth extending in primary hospital.