摘要
目的探讨额叶脑挫裂伤早期微创锥颅的疗效。方法对35例GCS≥8分的额叶脑挫裂伤患者早期采用YL-1型一次性颅内血肿粉碎穿刺针在局麻下经皮锥颅穿刺碎吸血肿及坏死的脑组织,再从锥颅针内注入NS 2 ml＋尿激酶2万U进行微创锥颅血肿及坏死脑组织抽吸术。结果 33例患者通过早期微创锥颅尿激酶溶解方法均治愈,疗效满意。2例患者分别于手术后第1天和第3天复查CT示血肿量有所减少,但脑水肿较前明显,中线结构偏移,同侧脑室受压消失,随行开颅去骨瓣减压手术,术后恢复良好。全部病例随访6个月-3年,按GOS评分恢复良好29例,占82.8%;中残6例,占17.1%。无重残及死亡。结论早期微创血肿抽吸术是治疗额叶脑裂伤的一种简单有效的方法,适用于广大基层医院开展,能提高生存率,减少精神症状,改善生活质量。
Objective To investigate the durative effects of early minimally invasive surgery on evacuating intracranial hematoma of patients with frontal brain contusion.Methods Thirty five frontal brain contusion patients with GCS more than 8 points were enrolled in this study.The intracranial hematoma and necrotic brain tissues were early smashed and removed by using the type YL-1 puncture needle under local anesthesia condition.Then 2 ml NS ＋ 2 million units urokinase was injected by the needle,the hematoma and necrotic brain tissue aspiration were performed again.Results All 33 patients were cured by using the minimally invasive surgery,and the results were satisfactory.There were two cases with obviously brain edema,midline shift,pressure in the lateral ventricles disappeared at day 1 to day 3 after the operation,and the decompressive craniectomy was performed in them,a good outcome was obtained.All patients were followed for 6 months to 3 years,a good recovery according to GOS scores was obtained in 29 cases（82.8%）;6 cases were with disability（17.1%）.No severe disability and death case was found.Conclusion The early t minimally invasive surgery is a simple and effective method for frontal brain contusion.It can increase the survival rate,reduce psychotic symptoms and improve the quality of life of patients,and can be widely carried out in primary hospitals.
出处
《中华全科医学》
2011年第7期1063-1063,1092,共2页
Chinese Journal of General Practice
关键词
额叶脑挫裂伤
微创清除术
疗效
Frontal brain contusion
Minimally invasive surgery
Effect
