微创置管引流治疗高血压性脑出血70例疗效观察

目的 观察微创钻孔置管引流手术治疗高血压性基底节区脑出血的临床价值.方法 回顾性分析我院2009年1月至2015年1月行微创钻孔置管引流术的70例高血压性基底节区脑出血患者的临床诊治资料.结果 70例患者均顺利实施手术,术后24 h内复查头颅CT,32.86%(23/70)患者血肿清除量在90%以上,54.29%(38/70)患者血肿清除量在80%~50%之间,12.86%(9/70)患者血肿清除量在50%以下.随访6个月,采用日常生活能力量表(ADL)评价患者预后,患者均成功获得随访,Ⅰ级患者60.00%(42/70),Ⅱ级患者32.86%(23/70),Ⅲ级患者5.71%(4/70),Ⅳ级患者1.43%(1/70),Ⅴ级患者0.结论 对于出血量在20~40 ml且尚未出现脑疝的高血压性基底节区脑出血患者,在血压控制稳定后行微创置管引流术治疗,效果良好,具有手术创伤小、术后出血率低和操作简单的优点.

Clinical analysis of minimally invasive catheter drainage surgery in the treatment of 70 cases of hypertensive cerebral hemorrhage

Objective To evaluate the clinical results and significance of minimally invasive drilling and drain-age in the treatment of hypertensive basal ganglia hemorrhage. Methods A retrospective study was performed of 70 pa-tients who underwent minimally invasive catheter drainage for hypertensive basal ganglia hemorrhage between January 2009 and January 2015 in our hospital. Results After 24 hours of surgery, checking with head CT, 32.86%(23/70) pa-tients had 90%hematoma clearance, and 54.29%(38/70) of patients had 50%~80%hematoma clearance, with 12.86%(9/70) of patients having hematoma clearance below than 50%. Six months later, the prognosis of patients was evaluated with the activities of daily living (ADL), the proportion of patients have recovery at gradeⅠ, gradeⅡ, gradeⅢ, gradeⅣand gradeⅤrespectively with 60.00%(42/70), 32.86%(23/70), 5.71%(4/70), 1.43%(1/70) and 0. Conclusion For non-hernia patients with hypertensive basal ganglia hemorrhage, for the amount of bleeding between 20 mL and 40 mL, minimally invasive catheter drainage surgery after blood pressure under control and stabilization has the advantages of simple, high efficiency, low postoperative bleeding rate and small surgical trauma.