摘要
【目的】探讨微创术治疗高血压性脑出血的疗效、影响疗效的因素及微创术最佳时机。【方法】180例高血压性脑出血患者依cT片简易三维立体定位后，用YL-1型一次性血肿粉碎穿刺针穿刺血肿靶点，进行抽吸、冲洗及应用生化、酶技术将血肿液化，对血肿进行冲刷、融碎、液化、引流，达到血肿清除及治愈病人的目的。【结果】180例中好转治愈158例，死亡22例，总有效率87．77％，病死率12．22％，对存活的158例，3个月后据ADI，分级法，ADL Ⅰ～Ⅲ级者129例，治疗良好率高达71．67％，重残率16．11％。明显优于内科保守治疗和开颅手术治疗。微创术以发病后6～24h组再出血率低，存活者生活质量较高。【结论】微创术治疗高血压性脑出血，损伤小，便于操作，尿激酶对血凝块溶解效果确切，明显降低了患者的病死率及致残率，微创术是治疗高血压性脑出血的最佳方法。结合文献报道作者认为：微创术实施最佳时机是发病后6～12h。
[Objective]To discuss the curative affect of hypertensive cerebral hemorrhage treated by microtraumatic operation（MTO）, the factors influencing the curative effect and the best opportunity of MTO. [Methods]After 180 cases of hypertensive cerebral hemorrhage patients were simply and three-dimensionally located according to CT film, puncture of hematoma target was made by one-off smashing acus of LY-1, to pump, rinse and then fluidify the hematoma by the biochemical and enzymatic technology, to melt and clear away the hematoma. [Results]One hundred and fifty eight cases were improved or cured. 22 cases died among 180 cases. The total curative ratio was 87.77% and the dead ratio was 12.22%. After three months, the living 158 cases were classified by the ADL classifying method, 129 cases belonged to the first to third ADL. The curative ratio amounted to 71.67% and serious to cripple ratio was 16.11%. The curative result was obviously supeior to the effect of medical conservative therapy and open neurosurgery. The MT（） made the re-bleeding ratio lower during the 6-24 hours of hemorrhage and the qualities of life higher. [Conclusion]MTO is convenient and minimally invasive. Urokinase can melt blood clot and obviously reduce the dead ratio and the cripple ratio. MTO is the best way to treat hypertensive cerebral hemorrhage. The best opportunity of operation is 6-12 hours after hemorrhage.
出处
《医学临床研究》
CAS
2006年第7期1014-1016,共3页
Journal of Clinical Research
