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目的探讨CT定位下锥颅尿激酶溶凝后引流治疗外伤性硬脑膜外血肿的临床实践与应用价值。方法49例外伤性硬脑膜外血肿在CT定位下直接锥颅穿刺血肿,留置引流管注入尿激酶,使血肿液化后经引流管排出。结果48例经2～4次重复注入尿激酶溶凝引流,2～5d后血肿基本消失。1例第二次注药后少量再出血,未再次注药。无1例出现并发症或改为开颅血肿清除术。结论CT定位,局麻下锥颅置入引流管,注入尿激酶溶凝后引流血肿,是治疗外伤性硬脑膜外血肿一种安全有效、创伤小、简便易行的好方法。它适用于急性、亚急性及慢性未发生脑疝的外伤性硬膜外血肿。
Objective To investigate the clinical practice and application value of condyle intracranial extracapsular hematoma after conception and drainage by CT skull catheterization. Methods Forty-nine cases of traumatic epidural hematoma were directly conical cranial puncture hematoma under CT localization, and urokinase was placed indwelling drainage tube to make the hematoma liquefied and drained through drainage tube. Results 48 cases of 2 ~ 4 times after repeated injection of urokinase coagulation and drainage, 2 ~ 5d hematoma disappeared. A case of a second dose of a small amount of re-bleeding after injection, did not re-injection. No one had complications or changed to craniotomy. Conclusions CT positioning, local anesthesia under the skull into the drainage tube, urokinase infusion of hematoma after injection of coagulation is a safe and effective treatment of traumatic epidural hematoma, trauma, easy and good method. It is suitable for acute, subacute and chronic traumatic brain herniation without epidural hematoma.