计算机辅助、CT导向血肿碎吸治疗高血压脑出血

目的 :为探索高血压脑出血安全有效的治疗方式。方法 :对 5 2例基底节区高血压脑出血患者 ,出血量在2 5ml～ 6 5ml。采用计算机辅助、立体定向与CT结合定位 ,局麻经颞部钻孔放置特制血肿螺旋抽吸针 ,在间断负压作用与生理盐水反复冲洗和螺旋针芯搅动下将血肿大部清除。术后立即复查CT确定残留血肿量 ,决定是否进行进一步的血肿腔尿激酶 (UK)溶解治疗。结果 :35例血肿手术清除达 80 %以上 ,术后不必进行血块溶解治疗 ,10例血肿清除在 5 0 %～ 80 %之间 ,7例血肿清除小于 5 0 % ,术后继续进行血肿腔血块溶解治疗。死亡 8例 ,死亡率 15 .4 % ,优良 36例 ,优良率 70 %。结论 :计算机辅助、CT引导立体定向高血压脑出血血肿碎吸术是治疗中等出血量出血的安全有效的方法

Treutment for hypertensive Cerebral Hemorrhege by Hematoma broken and taken out Technique Assisted by Computer and Directed by CTnical reports

Objective: To explore a safe and effective method to cure hypertensive cerebral hemorrhege. Methods: The diagnosis,operation and curative resluts of 52 cases of hypertensive cerebral hemorrhege whose hemorrhege amount was 25ml～65ml were summarized. Assisted by computer and stereoscopically, directed with CT, the temporal after local anesthesia and correct place were drilled with the specially-made hematoma spiral needles. Under the interval function of negative pressure, most hematoma by repeatedly washing with phydiological saline and stirred by spiral needles were cleaned. After the operation, CT was used immediately to determine left hematoma to decide if further of dissolving UK treatment was necessary.Results: More than 80% hematoma of 35 cases was cleaned by operation and hematoinalysis was not necessary cure,10 case (50%～80%) and 7 case (less than 50%) dissolution was necessary, after operation 8 case died,the death rate was 15.4%. 36 cases were excellent and the excellent rate was 70%.Conclusion: It is a safe and effective method to cure hypertensive cerebral hemorrhege of medium amount by hematoma-broken-and-taken out technique asssisted by compater and directed by CT.