密闭式颅内血肿引流冲洗器在高血压性脑出血穿刺引流中的应用价值

目的探讨密闭式颅内血肿引流冲洗器在高血压性脑出血穿刺引流中的应用价值。方法根据CT定位,锥颅置入密闭式颅内血肿引流冲洗器的颅内引流管,再外接密闭式引流器的颅外部分,使用该引流器的塑料吸球自动抽吸和三通管的丁基胶帽在完全密闭的情况下注入尿激酶等血凝块溶化药物,通过调节滴壶的高度进行持续抽吸引流,治疗高血压性脑出血35例。结果住院40～65d。出院时治愈6例,显著进步11例,进步13例,总有效率86%（30/35）;死亡5例,死亡率14%。血肿清除时间1～3.5d,平均2.7d。再出血3例,发生率为9%。无气颅、颅内外感染。生存的30例随访3～6个月,日常生活能力（ADL）分级,Ⅰ级7例,Ⅱ级8例,Ⅲ级12例,Ⅳ级3例。结论使用密闭式颅内血肿引流冲洗器,治疗程序简便,血肿清除快,治疗效果满意。

Intracranial Hematoma Drainage in the Treatment of Hypertensive Cerebral Hemorrhage by a Closed Drawing and Washing Apparatus

Objective To observe the efficacy of intracranial hematoma drainage by a closed drawing and washing apparatus for hypertensive cerebral hemorrhage. Methods Totally 35 cases with hypertensive cerebral hemorrhage were enrolled in this study. We inserted an intracranial drainage tube under the guidance of CT,and then connect the outer partial of the drainage apparatus,so that to use its bulb pipet pump to auto suck and T-band pipe to drop in Urokinase. The liquid inflow speed was controlled by adjusting the level the dropper height. Results The patients were discharged in 40-65 days. Six of them were cured,11 were significantly improved,and 13 cases were improved. The total effective rate was 86% （30/35）. Five patient died （death rate 14%） after the surgery. The duration of blood clot drainage ranged from 1 to 3.5 days （average 2.7 days）. Three cases （9%） developed re-hemorrhage. No pneumocephalus of infection occurred. The 30 patients who survived were followed up for 3-6 months. The Activity of Daily Living （ADL） evaluation showed grade Ⅰ in 7 cases,grade Ⅱ in 8 cases,grade Ⅲ in 12 cases,and grade Ⅳ in 3 cases. Conclusion Closed drawing and washing is a simple and effective procedure for Hypertensive Cerebral Hemorrhage with satisfactory outcomes.