血肿微创穿刺术在急性硬膜下血肿并脑疝患者急救中的应用.docVIP

血肿微创穿刺术在急性硬膜下血肿并脑疝患者急救中的应用 宋保新 欧洋 李长宝 王长成 王岩 王有全 （北京市平谷区医院脑外科 北京 101200） [摘要] 目的：探讨早期血肿微创穿刺术对急性硬膜下血肿合并脑疝患者的急救作用。方法：回顾分析我院在2005年1月至2012.12月期间在我科手术治疗的236例急性硬膜下血肿合并脑疝患者的临床资料，根据开颅术前是否进行早期血肿微创穿刺分为2组，早期利用YL-1型颅脑穿刺针行血肿微创穿刺者130例（微创穿刺组），对照组（非穿刺组）106例，根据GOS预后评分比较二组患者的治疗效果。结果：伤后6月至1年随访，微创穿刺组： GOS4～5分35例（26.9%）； GOS2～3分32例（24.6%）； GOS1分63例（48.5%）。对照组： GOS4～5分16例（15.1%）； GOS2～3分25例（23.6%）； GOS1分65例（61.3%）。微创组预后良好/中残（GOS4~5分）明显优于对照组（P＜0.05）（GOSP＜0.05）Application of microinvasive craniopuncture technique in treating cases with acute subdural hematoma and brain herniation SONG Baoxin, OU Yang, LI Changbao, WANG Changcheng, Wang Yan, Wang Youquan. Department of Neurosurgery, Pinggu district hospital, Beijing, China, 101200 [Abstract] Aim to evaluate the effect of microinvasive craniopuncture technique on patients with subdural hematoma and brain herniation. Methods Data of 236 cases with subdural hematoma and brain herniation between 2005.1 and 2012.12 were collected. Prompt drainage of subdural hematoma through microinvasive craniopuncture with YL-1 puncture needle was applied in 130 cases as first aid before craniotomy, in comparision with the left 106 cases. Glasgow Outcome Scale(GOS) was used to assess the result. Results the patients were followed up between 6 months and one year. GOS scores were as follows: 4~5 scores in 35 patients, 2~3 scores in 32 patients and 1 score in 63 patients in the microinvasive craniopuncture group, while 4~5 scores in 16 patients, 2~3 scores in 25 patients and 1 score in 65 patients in the control group. Conclusion Prompt drainage of subdural hematoma through microinvasive craniopuncture with YL-1 puncture needle as first aid improves the therapeutic effect in treating cases with subdural hematoma and brain herniation . [Key words] acute subdural hematoma ; brain herniation; YL-1 puncture needle; microinvasive craniopuncture 急性硬膜下血肿合并脑疝在临床上病情凶险，常常迅速恶化而导致患者死亡，只有采取及时有效的处理措施降低颅内压才可能挽救病人生命。现收集2005年1月至2012.12月期间在我科住院并手术治疗的236例急性硬膜下血肿合并脑疝患者的