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目的探讨微创穿刺术在急诊抢救外伤性颅内血肿的应用价值。方法回顾性分析2006年1月到2009年12月于齐齐哈尔市公安医院应用微创穿刺术抢救脑疝阶段的外伤性颅内血肿患者126例的临床资料,以术前CT片为依据,确定穿刺点、置管方向及深度,在急诊手术室局麻下行微创穿刺并置管引流的方法。结果本组穿刺成功率100%。瞳孔散大患者经引流后瞳孔均有不同程度缩小,单侧瞳孔散大组79/95例(83.1%);双侧瞳孔散大组17/31(54.8%),以临床即时效果评价的总有效率76.2%。根据GOS结果分级:良好48例,中残26例,重残18例,植物生存16例,死亡18例。结论微创穿刺术可快速改善脑疝症状,缩短脑疝时限,延长开颅手术的时间窗,是一种有效的抢救手段,同是也是创伤急救医师有必要掌握的一种确定性救命手术技术。
Objective To investigate the value of minimally invasive puncture in the emergency treatment of traumatic intracranial hematoma. Methods A retrospective analysis of 126 cases of traumatic intracranial hematoma patients who underwent minimally invasive puncture at the Public Security Hospital of Qiqihar from January 2006 to December 2009 was retrospectively analyzed. Point, direction and depth of catheter placement in the emergency room under local anesthesia minimally invasive puncture and catheter drainage method. Results of this group puncture success rate of 100%. Dilated pupils were dilated pupils were reduced to varying degrees, unilateral mydriasis 79/95 cases (83.1%); bilateral mydriasis 17/31 (54.8%), the clinical immediate effect of the total Effective rate of 76.2%. According to the results of GOS grading: good in 48 cases, 26 cases of disability, severe disability in 18 cases, plant survival in 16 cases, 18 cases of death. Conclusion Minimally invasive puncture can rapidly improve the symptoms of cerebral hernia, shorten the time of hernia, and prolong the time window of craniotomy. It is an effective rescue method and a definitive lifesaving technique that trauma emergency physicians need .