经额部锥颅置管引流治疗基底节区血肿的治疗体会

目的分析和探讨高血压脑出血患者经额钻单孔置管引流治疗的效果。方法对2003年3月至2007年3月收治的98例基底节区脑出血患者在发病5~72 h内经额部钻单孔置管引流,尿激酶溶化血肿。结果该组病例术中血肿抽吸清除量达总量2/3以上者82例。术前GCS评分9~15分42例均存活,6~8分38例中存活30例,3~5分18例中存活5例。出院时治疗效果按GOS分级:良好42,轻残21例,重残11例,植物状态3例,死亡21例。结论经额部钻单孔置管引流治疗高血压脑出血简单易行,不受年龄限制,创伤小,意识恢复快,神经功能恢复好,病死率低,适用用于基层医院。

Experience of Basal Ganglia Hematoma Treated with Drilling Skull Trans-Fribtal Region for Catheter Drainage

Objective To analyse and investigate the effect of hypertensive cerebral hemorrhage trea- ted by drilling frontal singulare and dranage. Methods Drainage by drilling frontal singulare, and melted hematoma with urokinase were performed on 98 patients with basal ganglia cerebral hemorrhage within 5 hours to 72 hours from March,2003 to March ,2007. Results The hematoma of 82 patients were cleaned out over 2/3 of the whole amount. 42 patients with GCS score between 9 and 15 before the operation all are survived. 30 patients out of 38 with GCS score between 6 and 8 are survived. 5 patients out of 18 with GCS score between 3 and 5 are survived. The therapeutic efficacy were classified by Gos when patients left hospital： Fine 42 （42.86 % ）, mildly disabled 21 （ 21.43 % ）, severely disabled 11 （ 11.22 % ）, plant man 3 （3.06%）, dead 21 （21.43 % ）. Conclusion Frontal drainage hole drilling is an easy and convenient treatment for hypertensive cerebral hemorrhage. There does not limited by age, and come with little wound. The patients could recover conscious rapidly, good recovery of neurological function and lower mortality. It is suitable for the primary level hospital.