小骨窗开颅、尿激酶溶解引流治疗高血压脑出血的效果分析  

The curative effect analysis of small bone window craniotomy combines with urokinase in the treatment of hypertensive cerebral hemorrhage

作　　者：陈勇 黄岩松 王兵[2] 

机构地区：[1]浙江省湖州市南浔区人民医院神经外科,浙江湖州313009 [2]山东省肿瘤防治研究院,山东济南250117

出　　处：《中国医药导报》2013年第31期44-46,共3页China Medical Herald

基　　金：山东省自然科学基金项目(编号ZR2009BM38)

摘　　要：目的探讨小骨窗开颅、尿激酶溶解引流治疗高血压脑出血的临床疗效。方法选择浙江省湖州市南浔区人民医院2008年12月-2011年2月收治的高血压脑出血患者60例，按照治疗方法不同分为观察组和对照组，每组各30例。对照组采用传统开颅手术治疗，观察组采用小骨窗开颅、尿激酶引流治疗，比较两组患者的治疗效果。结果①观察组手术时间[（93．0±14．4）min]、GCS评分（（8．1±2．5）分]、COS良好率[66．7％（20／30）]明显优于对照组[（121．7±18．7）min、（10．2±3．4）分、50．0％（15／30）]，差异有统计学意义（P〈0．05）；两组患者的残留血肿量差异无统计学意义（P〉0．05）；②观察组并发症总发生率（23.3％）明显低于对照组（43.3％），差异有统计学意义（P〈0．05）；③两组治疗后NDF评分均优于同组治疗前，治疗后观察组NDF评分【（25．42±5．14）分】优于对照组【（18．51±3．08）分】，差异均有统计学意义（均P〈0．05）。结论小骨窗开颅、尿激酶溶解引流治疗高血压脑出血的效果较好，可有效促进患者神经功能恢复，且并发症少，值得临床推广。Objective To investigate the curative effect of small bone window craniotomy combine with urokinase in the treatment of hypertensive cerebral hemorrhage. Methods 60 cases of hypertensive cerebral hemorrhage patients in the People＇s Hospital of Nanxun District in Huzhou City from December 2008 to February 2011 were divided into observation group and control group with 30 cases in each group according to different treatments. The control group was used the traditional cran- iotomy operation treatment, the observation group was treated with small bone window craniotomy, urokinase drainage treatment, and the curative effect was compared between the two groups. Results （1） The operation time [（93.0±14.4） min], GCS scores [（8.1±2.5） scores], GOS good rate [66.7% （20/30）] in the observation group were better than those in the control group [（121.7±18.7） min, （10.2±3.4） scores, 50.0% （15/30）], the differences were statistically significant （P 〈 0.05）. Residual hematoma volume in the two group was found had no statistically significant difference （P 〉 0.05）. （2）Overall complication in- cidence in observation group （23.3%） was lower than that in control group （43.3%）, the difference was statistically significant （P 〈 0.05）. （3）After treatment NDF scores in the two groups was found had better than before treatment, after treatment NDF scores in observation group [（25.42±5.14） scores] was better than that in control group [（18.51±3.08） scores], the difference was statistically significant （P 〈 0.05）. Conclusion The curative effect of small bone window craniotomy and urokinase drainage in the treatment of hypertensive cerebral hemorrhage is better, it can promote the recovery of neurological function effectively, and has fewer complications that is worthy of clinical application.

关 键 词：小骨窗开颅 尿激酶 颅内血肿 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]