Mohadjer M, Braus D F, Myers A, Scheremet R, Krauss J K
Department of Neurosurgery, University of Freiburg Medical School, Fed. Rep. of Germany.
Neurosurg Rev. 1992;15(2):105-10. doi: 10.1007/BF00313504.
CT-stereotactic fibrinolysis is an effective alternative to surgical and conservative therapies for intracerebral hematoma. The method consists of stereotactically puncturing and partially evacuating the hematoma. After fibrinolysis using urokinase, the residual hematoma is completely evacuated through a catheter inserted in the cavity of the hematoma. The operation is usually performed under local anesthesia. Stereotactic methods are safer and less invasive than other methods. Since October 1985, a total of 85 patients have been treated with this method in the Department of Stereotaxy and Neuronuclear Medicine at the University of Freiburg Medical School. Although 25 patients died (29.4%) during the mean follow-up period of 20 months, only 16 (18.8%) died in the acute postoperative phase or within the first 60 days after evacuation. Eighteen patients (21.2%) had died six months after the operation. The quality of life of the 60 surviving patients, as measured on the Karnofsky Scale at follow-up, was very good to good in 70% and moderate in 23.3%. Only 6.7% of the patients were so disabled that they required special care and assistance or had to be placed in a nursing home. The long-term results are thus very encouraging.
CT立体定向纤维蛋白溶解术是治疗脑内血肿的一种有效替代手术和保守治疗的方法。该方法包括立体定向穿刺和部分清除血肿。使用尿激酶进行纤维蛋白溶解后，通过插入血肿腔内的导管将残余血肿完全清除。手术通常在局部麻醉下进行。立体定向方法比其他方法更安全、侵入性更小。自1985年10月以来，弗赖堡大学医学院立体定向与神经核医学科共有85例患者接受了该方法治疗。尽管在平均20个月的随访期内有25例患者死亡（29.4%），但只有16例（18.8%）在术后急性期或血肿清除后的前60天内死亡。18例患者（21.2%）在术后6个月死亡。随访时根据卡诺夫斯基量表测量，60例存活患者的生活质量70%为非常好至良好，23.3%为中等。只有6.7%的患者残疾严重，需要特殊护理和帮助或不得不入住疗养院。因此，长期结果非常令人鼓舞。
