重型脑室出血灌注尿激酶后不同保留时间的疗效观察  

Clinical observation of different retention time after infusing of urokinase in the treatment of severe ventricular hemorrhage

作　　者：郭金光[1] 李海燕[2] 王绍飞[3] 杨辉[4] 张晓娟[1] 吝晓尧 

机构地区：[1]冀中能源峰峰集团总医院神经外科,河北邯郸056200 [2]冀中能源峰峰集团总医院骨五科,河北邯郸056200 [3]冀中能源峰峰集团总医院输血科,河北邯郸056200 [4]冀中能源峰峰集团总医院骨一科,河北邯郸056200

出　　处：《中华神经外科疾病研究杂志》2017年第5期432-436,共5页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的观察重型脑室出血行双侧脑室穿刺外引流灌注尿激酶后不同保留时间对疗效的影响。方法回顾分析70例行双侧脑室穿刺外引流的重型脑室出血患者的临床资料,按尿激酶保留时间长短分为3组,A组(23例)保留1 h、B组(25例)保留2 h、C组(22例)保留3 h,观察比较每组患者在不同时间段血肿完全消散例数,住院时间,发病3个月内延期性脑积水发生率,发病6个月后的预后等。结果血肿消散情况三组间比较差异有统计学意义(P<0.05),A组与B组、A组与C组间比较差异均有统计学意义(P<0.017),B组与C组间比较差异无统计学意义(P>0.017),住院时间三组间比较差异有统计学意义(P<0.05),A组和B组间、A组和C组间比较差异有统计学意义(P<0.05),B组和C组间比较差异无统计学意义(P>0.05)。延期性脑积水发生情况比较差异有统计学差异(P<0.05),A组与B组、A组与C组间比较差异有统计学意义(P<0.05),B组与C组间比较差异无统计学意义(P>0.05),预后比较差异无统计学意义(χ2=1.705,P>0.05)。结论尿激酶脑室内保留2 h对重型脑室出血外引流是比较合适的。Objective The effect of different retention time of urokinase on the treatment of severe ventricular hemorrhage after bilateral ventriculostomy was observed. Methods The clinical data of 70 patients with severe ventricular hemorrhage undergone bilateral ventriculostomy were retrospectively analyzed. These patients were divided into 3 groups according to the retention time of urokinase： Group A （23 patients） with retention time of urokinase for 1 h, Group B （25 patients） for 2 h, Group C （22 patients） for 3 h. The nunlber of patients with complete hematoma dissipation at different time, admission time, delayed hydrocephalusat within 3 months, prognosis after 6 months in each group were observed. Results The hematoma dissipation in three groups had significant difference （P 〈0.05）. The hematorrm dissipation between Group A and Group B, and between Group A and Group C had statistically significant differences （P 〈 0. 017 ）. But there was no significant difference between Group B and Group C （P〉0.017）. The admission time in three groups had statistically significant difference （P 〈0.05）, and so had between Group A and Group B and between Group A and Group C （ P 〈 0. 05 ）, But there was no significant difference between Group B and Group C （P 〉 0. 05）. The delayed hydrocephalus in three groups had significant difference （P 〈0.05）, so had between Group A and Group B and between Group A and Group C （P 〈0. 05）. But there was no significant difference between Group B and Group C （P 〉0. 05）. The results of prognosis after 6 months in three groups had no significant difference （X^2 = 1.705, P 〉 0. 05）. Conchlsion The retention time of urokinase for 2 h is mere suitable for the patients with severe ventricular hemorrhage who undergo external drainage.

关 键 词：重型脑室出血 尿激酶 血肿消散 住院时间 延期性脑积水 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]