立体定向抽吸血肿辅以大剂量尿激酶治疗幕上脑出血  

Using stereotactic aspiration combined with instillation of large dosage urokinase in treating patients with supratentorial intracerebral hemorrhages

作　　者：毛群[1] 勾俊龙[1] 邢复明[1] 曾宪起[1] 杨川[1] 魏金祥[1] 张毅[1] 赵辉[1] 刘宗惠[2] 

机构地区：[1]天津市第三医院神经外科天津市老年医学研究所,300250 [2]北京海军总医院神经外科中心

出　　处：《中国脑血管病杂志》2004年第7期306-308,共3页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨立体定向辅以大剂量尿激酶治疗幕上脑出血的可行性和有效性.方法以立体定向技术,手术抽吸血肿并置入导管,术后注入大剂量尿激酶,治疗幕上脑出血106例.手术中根据血肿量抽吸血肿的50%～80%,术后每日向引流管内注入尿激酶2次,每次每管注入5万U,间隔12 h.结果30 d内死亡23例,病死率为21.69%;术后再出血6例,占5.67%;术后再出血所致的死亡1例,占0.94%;入院时已有脑疝的患者,30 d病死率为60%.结论立体定向结合大剂量尿激酶治疗幕上脑出血安全有效,根据血肿量的大小和术前是否有脑疝存在,手术中清除血肿量以50%～80%为宜.Objective To evaluate the feasibility and effectiveness of stereotactic aspiration combined with large dosage of urokinase in treating patients with supratentorial intracerebral hemorrhages . Methods 106 cases with supratentorial intracerebral hemorrhages were treated by stereotactic aspirationand drainaged with instillation of large dosage of urokinase. 50% - 80% of the total volume of hematomas were aspirated using stereotactic techniqne and 50 000 U of urokinase was administrated after operation two times a day though a drainage lube. Results The 30-days mortality was 21. 69% . 6 cases were suffered from rebleeding after operations (5. 66% ), and 1 case died (0. 94% ). The 30-day mortality was 60% in patients with signs of brain herniations on admission. Conclusion It is safe and effective for stereotactic aspiration combined with instillation of large dosage of urokinase in treating patients with supratentorial intracerebral hemorrhage. 50% -80 % of hematomas should be aspirated out in operations according to the total volumes of hematomas and signs of brain herniation.

关 键 词：立体定向 血肿抽吸 大剂量 尿激酶 治疗 幕上脑出血 可行性 有效性 

分 类 号：R651[医药卫生—外科学]