自1998年以来,我们用CT引导下,后枕角入路钻孔抽血尿激酶溶解治疗高血压重症丘脑出血18例,取得显著疗效,现报告如下。 1 临床资料 1.1 一般资料:本组男性10例,女性8例,年龄最大77岁,最小56岁,平均65.7岁,均有高血压病史。 1.2 出血量及临床表现:出血量大于20ml。全部破入脑室,3例大部分破入脑室。6例破入基底结。深昏迷14例,4例浅昏迷。双侧瞳孔不等大16例,偏瘫18例。 1.3 治疗方式:全部为出血后6小时穿刺。在CT引导下,枕部旁开3cm选择穿刺点,局麻。选择丘脑层面。钻颅后,把带导针的穿刺硅胶管(直径4mm)从枕角三角区导入丘脑血肿中心,抽出导针,固定硅胶管。抽出一定量血液后,把6千u～1万u尿激酶溶于1ml的生理盐水,经硅胶管 Since 1998, we use CT-guided post-occipital horn drilling urokinase hemolysis treatment of hypertensive severe thalamic hemorrhage in 18 cases, and achieved significant results are as follows. 1 Clinical data 1.1 General Information: This group of 10 males and 8 females, the oldest 77 years old, minimum 56 years old, average 65.7 years old, have a history of hypertension. 1.2 bleeding and clinical manifestations: bleeding greater than 20ml. All broken into the ventricle, most of the 3 cases break into the ventricle. 6 cases broke into the base junction. Deep coma in 14 cases, 4 cases shallow coma. 16 cases of bilateral pupil ranging from large, hemiplegia in 18 cases. 1.3 treatment: all six hours after bleeding puncture. Under the guidance of CT, occiput next to open the 3cm choice puncture point, local anesthesia. Select the thalamic level. After drilling the skull, the punctured silicone tube (4mm in diameter) was introduced into the center of thalamic hematoma from the ciliary triangle and the guide pin was drawn out to fix the silicone tube. After a certain amount of blood is drawn, the 6-1000 u of urokinase is dissolved in 1 ml of normal saline and passed through a silicone tube