微创清除术治疗老年高血压性丘脑出血

目的探讨应用微创血肿清除术治疗老年高血压丘脑出血的方法及疗效。方法选择67例老年高血压丘脑出血病例,均在超早期或急性期行微创术。术前依CT平面导向定位,选择最佳的穿刺点、穿刺方向,清除血肿。结果治疗67例,近期疗效:优4例,占6.0%;良6例,占9.0%;中40例,占59.7%;差9例,占13.4%;死亡8例,死亡率11.9%。远期疗效:ADL17例,占10.4%;ADL211例,占16.4%;ADL320例,占30.0%;ADL411例,占16.4%;ADL54例,占6.0%;再死亡6例,共14例,占20.9%。结论微创血肿清除术设备设计合理,操作简便,针钻合一,易于固定,密闭性好,尿激酶溶血肿效果理想,引流效果好,安全、经济,处理老年高血压性丘脑出血有效,适合于基层医院开展。

THERAPY OF SENILE HYPERTENSIVE CEREBRAL HEMORRHAGE IN THALAMENCEPHALON BY MICROTRAUMA CLEANING OPERATION

Objective To discuss the means and curative effect of therapy of senile hypertensive cerebral hemorrhage in thalamencephalon by microtrauma cleaning operation. Methods 67 patients with senile hypertensive cerebral hemorrhage in thalamencephalon were treated by microtrauma cleaning operation in super early period or acute stage. To localize according to CT plane before operation. To clean hematoma by selecting the best spot and direction of puncture. Results In all the patients the excellent were 4;the good were 6;the ordinary were40; the bad were 9; the dead were 8. The percentage respectively was 6.0%, 9.0%, 59.7%, 13.4%, 11.9%. The longterm curative effect: ADL1 were 7; ADL2 were 11; ADL3 were 20; ADL4 were 11; ADL5 were 4. The percentage respectively was 10.4%,16.4%,30.0%,16.4%,6.0%. The second death were 6 and the total percentage of death was 20.9%. Conclusion Microtrauma cleaning operation is a therapy of reasonable design, simplicity, integration of needle and bodkin, easy to fix, good performance of sealing, ideal effect of dissolving hematoma with urokinase, good effect of draining, safety and economization. It is effective in treating senile hypertensive cerebral hemorrhage in thalamencephalon and can be popularized at the grass-root hospitals.