CAJ | 학술논문

目的探讨CT监视下YL-1型一次性使用颅内血肿粉碎穿刺针穿刺治疗高血压性脑出血的临床价值和疗效.方法选择80例高血压性脑出血患者,在CT监视下应用YL-1型一次性使用颅内血肿粉碎穿刺针穿刺引流血肿,间断用尿激酶冲洗并引流出残留血凝块.观察血肿体积减少量、手术时间、术前与术后格拉斯哥昏迷量表(GCS)评分、临床疗效及远期随访.结果手术时间15～ 45(25.0± 2.8) min；术后血肿体积减少率30％～ 80％ (56.8±3.2)％；GCS评分增加(2.3±0.3)分.随访2～24个月,80例患者死亡10例,70例幸存者进行日常生活能力(ADL)评估:ADL1级17例(24.3％),ADL2级36例(51.4％),ADL3级13例(18.6％),ADL4级3例(4.3％),ADL5级1例(1.4％).结论 CT监视下YL-1型一次性使用颅内血肿粉碎穿刺针穿刺治疗高血压性脑出血是一种简单快捷、定位准确、不用开颅和输血、安全有效的手术方式,但要注意手术适应证.
목적 탐토CT감시하YL-1형일차성사용로내혈종분쇄천자침천자치료고혈압성뇌출혈적림상개치화료효.방법 선택80례고혈압성뇌출혈환자,재CT감시하응용YL-1형일차성사용로내혈종분쇄천자침천자인류혈종,간단용뇨격매충세병인류출잔류혈응괴.관찰혈종체적감소량、수술시간、술전여술후격랍사가혼미량표(GCS)평분、림상료효급원기수방.결과 수술시간15～ 45(25.0± 2.8) min；술후혈종체적감소솔30％～ 80％ (56.8±3.2)％；GCS평분증가(2.3±0.3)분.수방2～24개월,80례환자사망10례,70례행존자진행일상생활능력(ADL)평고:ADL1급17례(24.3％),ADL2급36례(51.4％),ADL3급13례(18.6％),ADL4급3례(4.3％),ADL5급1례(1.4％).결론 CT감시하YL-1형일차성사용로내혈종분쇄천자침천자치료고혈압성뇌출혈시일충간단쾌첩、정위준학、불용개로화수혈、안전유효적수술방식,단요주의수술괄응증.
Objective To study the clinical value and efficacy of intracranial hemorrhage smash puncture needle with YL-1 type disposable under CT monitoring in treatment of hypertensive intracerebral hemorrhage.Methods The data of 80 cases with hypertensive intracerebral hemorrhage patients who accepted the transcranial puncture under CT monitoring application of YL-1 type disposable intracranial hemorrhage smash puncture needle and drainage of hemorrhage,punctuated with urokinase washout and drainaged residual blood clot.Evaluation criteria:hemorrhage volume reduction,average operation time,preoperative and postoperative Glasgow coma scale (GCS) score,the clinical effect of long-term follow-up.Results Operation time was 15-45 (25.0 ± 2.8) minutes;hemorrhage volume was reduced by an average of 30％-80％ (56.8 ± 3.2)％,the average increase of GCS was (2.3 ±0.3) scores,10 cases death in 80 patients,70 survivors' activities of daily living (ADL) assessments:grade ADL 1 in 17 cases ( 24.3 ％ ),grade ADL2 in 36 cases( 51.4％ ),grade ADL3 in 13 cases ( 18.6％ ),grade ADL4 in 3 cases(4.3％ ),grade ADL5 in 1 case ( 1.4％ ).Conclusions YL-1 type disposable intracranial hemorrhage smash puncture needle under CT monitoring in the treatment of hypertensive intracerebral hemorrhage is a simple,fast and accurate positioning,without craniotomy and blood transfusion,safe and effective operation,but should pay attention to operation indications.