高血压性壳核出血微创治疗的临床研究

目的 研究应用微创液化引流术治疗高血压性壳核出血的疗效。方法 对187例高血压性壳核出血患者，在CT引导下，依据壳核血肿的形态、大小及患者的病情，选择适宜的穿刺点、方向，行CT平面导向下的微创液化引流术，清除血肿。结果 187例患者出院161例，死亡26例，病死率为13.9％；对125例患者随访6个月至7年，以13常生活活动量表(ADL)评估患者神经功能，ADL1 52例(41.6％)，ADL2 36例(28．8％)，ADL3 20例(16．0％)，ADL4 11例(8．8％)，ADL5 6例(4．8％)。结论 应用微创液化引流术治疗壳核出血，能最大限度地清除血肿，避免或减轻并发症，具有较大的优越性。

The clinical study on the treatment of putamen hemorrhage by minimally invasive surgery

Objective To evaluate the effectiveness of minimally invasive therapy in treating putamen hemorrhage. Methods CT was performed to show the form and volume of putamen hematoma before the surgery, and to determine the suitable point and direction of puncture. The hematoma was eliminated by minimally invasive aspiration and drainage which was guided under CT layer image. Results 187 cases were received the minimally invasive therapy, 161 cases were discharged and 26 cases died(mortality rate 13. 9% ). Follow-up study of 125 cases was done ranging from 3 months to 6. 5 years after surgery, showed that 52 cases(41. 6% ) , 36 cases(28. 8% ), 20 cases(16% ), 11 cases(8. 8% ), 6 cases(4. 8% ) were classified into Barthel index of activities of daily life(ADL) 1 -5 respectively. Conclusion Minimal invasive therapy of putamen hemorrhage has great superiority, such as it can elimination most part of the hematoma, and avoiding or decreasing complications.