锥颅软通道置管引流术治疗脑挫裂伤的疗效分析

目的探讨简易头皮定位下锥颅软通道置管引流治疗脑挫裂伤的效果。方法 2012年1月至2013年6月对28例脑挫裂伤患者在头皮简易定位下行锥颅软通道置管引流术治疗,用尿激酶3万~5万U溶解血肿。结果 28例中,转行开颅手术2例,其中死亡1例,23例治愈,4例好转出院。存活的27例病人出院后随访6~18个月,按日常生活能力量表评定患者远期疗效：Ⅰ级19例,Ⅱ级3例,Ⅲ级3例,Ⅳ级1例,Ⅴ级1例;复查头颅CT发现脑积水1例（3.8%）。结论锥颅置管引流术治疗脑挫裂伤是一种简单易行、创伤小、恢复快的治疗方法,适合于未发生脑疝的患者。

Analysis of therapeutic effect of cranial puncture and soft channel catheter drainage on cerebral contusion and laceration

Objective To investigate the therapeutic effect of cranial puncture and soft channel catheter drainage on cerebral contusion and laceration （CCL）. Methods The cranial puncture and soft channel catheter drainage by scalp marker-guided location and subsequent fibrinolysis with urokinase were performed in 28 patients with CCL from January, 2012 to June, 2013. Results Of 28 cases, 23 were cured, 4 were on the mend and discharged from hospital, and 1 of 2 patients undergoing craniotomy due to the poor effect of the drainage died. Of 27 survival patients followed up from 6 to 18 months, 19 belonged in activities of daily living （ADL） grade Ⅰ , 3 in grade Ⅱ, 3 in grade Ⅲ, 1 in grade Ⅳ and 1 in grade Ⅴ. No hydrocephalus was found by cerebral CT re-examination in 27 patients. Conclusion The cranial puncture and soft channel catheter drainage is a simple and practicable method to treat CCL patients without cerebral hernia.