微创钻孔引流结合尿激酶治疗颞枕部硬膜外血肿的临床观察  

The Treatment of Combination of Minimally-invasive Surgical and Urokinase for Temporal Occipital Epidural Hematoma

作　　者：谭鑫[1] 张宗平[1] 陈春燕[1] 吴小花[1] 

机构地区：[1]广东省农垦中心医院神经外科,广东湛江524002

出　　处：《中国医药指南》2013年第26期6-8,共3页Guide of China Medicine

摘　　要：目的探讨微创钻孔引流结合尿激酶对颞枕部硬膜外血肿的治疗效果。方法2006年1月至2012年12月期间住院的颞枕部硬膜外血肿患者共52例，均在CT定位下以YL-1微创引流针穿刺血肿腔，并以尿激酶3万～5万IU冲洗引流，术后3d及7d行CT动态扫描，对比手术前后血肿量及格拉斯哥昏迷评分（GCS）的变化。结果48例采用微创结合尿激酶引流，血肿量术后3d（12.8±2．2）mL，术后7d（2．4±0．8）mL，均较术前的（26-3±8．2）mL显著减少（均P〈0．05）。术后7d平均GCS为（12.3±1．6）分，较术前的（7．8±2．4）分显著提高（P〈0．05）。4例术中改为硬脑膜扩大修＋去骨瓣减压术，其中2例术后死亡。结论微创钻孔引流结合尿激酶治疗硬膜外血肿患者疗效确切，创伤小且操作简便。Objective To investigate the therapeutic effect of combination of Minimally-invasive surgical and urokinase for temporal occipital epidural hematoma. Methods 55 patients with temporal occipital epidural hematoma, who had been in the hospitals .from January 2008 to May 2013, were managed with minimally-- invasive drainage under CT location, and 50 000 to 60 000 IU of urokinase was used for irrigation and drainage. CT scanning was performed 3d and 7d after operation and volumes of hematoma were calculated to contrast the change of of volumes of hematoma and Glasgow coma scale （GCS）. Result 48 cases were treated by combination of Minimally-invasive surgical and urokinase. The volumes of hematoma 3d, 7d after operation were （12.8±2.2）mL and （2.4±0.8）mL respectively, compared to before operation （26.3±8.2）mL （P〈0.05）. GCS 7d after operation was （12.3±1.6）, which was significantly higher than that before operation （7.8±2.4） （P〈0.05）. 4 cases were changed to dura mater expand ＋ to bone disc decompression during operation, including 2 cases death. Conclusions Combination of Minimally-invasive surgical and urokinase is effective in the treatment of traumatic temporal occipital epidural hematoma.

关 键 词：微创 引流 硬膜外血肿 格拉斯哥昏迷评分 

分 类 号：R743[医药卫生—神经病学与精神病学]