无框架立体定向下微创穿刺联合尿激酶治疗外伤性脑内血肿.pdf

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1、国际神经病学神经外科学杂志2013年第40卷第4期论著·无框架立体定向下微创穿刺联合尿激酶治疗外伤性脑内血肿肖胜，刘金，武永康1．扬州市第一人民医院西区神经外科，江苏扬州2250002．武汉大学附属鄂州市中心医院，湖北鄂州430000摘要：目的探讨在无框架立体定向仪下行微创穿刺联合尿激酶在外伤性颅内血肿中的应用。方法对2012年O2月～2013年01月37例外伤性颅内血肿患者的微创治疗疗效进行回顾分析。首先外伤性颅内血肿经CT检查确诊后在24小时内，行无框架立体定向微创穿刺后连接一次性颅内血肿清除套装引流，术后每日两次经套装注入尿激酶并引流积血。结果37例患者均治愈出院，肢体活动恢复正常2

2、9例(73．38％)，轻度残疾6例(16．22％)，2例出现重度对侧肢体偏瘫(5．4％)；13例出现失语症状(35．14％)，余患者恢复良好。住院时问最短7天，最长18天，平均住院时间为1O．7天。结论立体定向下微创穿刺定位准、疗效确切、创伤小，术后并发症低，有效地减轻了患者的经济负担。关键词：立体定向；微创穿刺；颅内血肿；尿激酶Framelessstereotacticminimallyinvasivepuncturecombinedwithurokinaseinjectionintreatmentoftraumaticintracranialhematoma1XiaoshengLiuf

3、inWu—yongkangDepartmentofNeurosurgeryYangzhouFirstPeople’SHospitalWestYangzhouofJiangsupraise，225000China．2Imagingdepartmentofthefirstpeople’SHospitalofEzhouCity．Ezhouofhubeipraise，430000China．Abstract：ObjectiveToinvestigatetheapplicationofframelessstereotacticminimallyinvasivepuncturecombinedwith

4、urokinasein—jectioninthetreatmentoftraumaticintracranialhematoma．MethodsAretrospectiveanalysiswasperformedtoinvestigatethetreat—mentoutcomesof37patientswithtraumaticintracranialhematomawhoreceivedminimallyinvasivetreatmentfromFebruary2012toFebruary2013．Framelessstereotacticminimallyinvasivepunctur

5、eanddrainageusingadisposableintracranialhematomaremovalsetwereperformedwithin24hoursaftertraumaticintracranialhematomawasconfirmedbyCTscanning，andurokinaseinjectionandblooddrainageusingtheintracranialhematomaremovalsetwereperformedtwicedailyafteroperation．ResultsAllthe37patientswerecuredanddischar

6、ged．Twenty—ninecases(73．38％)hadafullrecoveryofphysicalactivity，6cases(16．22％)hadmildphysicaldisability，and2cases(5．4％)hadseverecontralateralhemiplegia；13cases(35．14％)hadaphasia，andothercaseshadagoodre-coveryoflanguagefunction．Thelengthofhospitalstayrangedfrom7to18days．withameanof10．7days．Conclusio

7、nsStereotacticminimallyinvasivepuncturehasaccuratepositioning，positiveefficacy，mildtrauma，andfewcomplications，andcanreducetheeconom’icburdenofpatients．Keywords：stereotactic；minimallyinvasivepuncture；intracranialh