颅内血肿穿刺外引流联合尿激酶冲洗治疗高血压脑出血的疗效分析  

Curative effect of puncture and drainage of intracranial hematoma combined with urokinase irrigation on hypertensive intracerebral hemorrhage

作　　者：黄诚衙 贾军[1] 刘子科[1] 董广宇[1] 吴春波[1] HUANG Chengya;JIA Jun;LIU Zike;DONG Guangyu;WU Chunbo(Department of Neurosurgery,Longgang District People's Hospital of Shenzhen,Shenzhen 518172,China)

机构地区：[1]深圳市龙岗区人民医院神经外科,广东深圳518172

出　　处：《中国实用神经疾病杂志》2019年第24期2752-2758,共7页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析颅内血肿穿刺外引流联合尿激酶冲洗治疗高血压脑出血的临床疗效。方法选取2016-01-2018-12于深圳市龙岗区人民医院诊治的60例高血压脑出血患者为研究对象,随机分为观察组及对照组各30例,其中对照组给予传统开颅术治疗,观察组给予颅内血肿穿刺外引流联合尿激酶冲洗治疗,比较2组临床疗效、术中出血量、手术创面、手术时间、住院时间、治疗费用、神经功能缺损变化、术后7 d颅内血肿体积、术后并发症发生率及治疗满意度。结果2组临床疗效、术中出血量、手术创面大小、手术时间、住院时间、治疗费用、术后7 d颅内血肿体积、并发症发生率、治疗满意度比较,差异均有统计学意义(P<0.05);2组术前神经系统功能缺损评分比较,差异无统计学意义(P>0.05),术后7 d、14 d、30 d,观察组神经功能缺损评分明显低于对照组,差异有统计学意义(P<0.05)。结论高血压脑出血出血量大于25 mL,部分患者形成脑疝,但处于脑疝早期、生命体征正常者,给予颅内血肿穿刺外引流联合尿激酶冲洗治疗,疗效显著。Objective To analyze the clinical effect of puncture and drainage combined with urokinase irrigation for Hypertensive intracerebral hemorrhage.Methods 60 patients with Hypertensive intracerebral hemorrhage treated in our hospital from January 2016 to June 2018 were rando mLy divided into observation group and control group,30 cases in each group.The control group was treated with traditional craniotomy,while the observation group was treated with intracranial hematoma puncture and drainage combined with urokinase irrigation.The treatment efficiency,intraoperative hemorrhage volume,surgical wound and operation time were compared between the two groups.Inter-hospital stay,treatment costs,changes in neurological deficits,intracranial hematoma volume 7 days after operation,incidence of complications and treatment satisfaction.Results The effective rate of treatment,intraoperative bleeding volume,surgical wound size,operation time,hospitalization time,treatment cost,intracranial hematoma volume,complication rate and treatment satisfaction of the two groups were all P<0.05,the difference was statistically significant;the preoperative nervous system function defect score of the two groups was P>0.05,the difference was not significant,7 days and 14 days after operation.At 30 days,the neurological deficit score of the observation group was significantly lower than that of the control group(P<0.05).Conclusion The amount of hypertensive intracerebral hemorrhage is more than 25 mL,and some patients have cerebral hernia,but in the early stage of cerebral hernia,the patients with normal vital signs are treated with puncture and drainage of intracranial hematoma combined with urokinase irrigation.The curative effect is remarkable,and the clinical application value is high,which is worthy of clinical promotion.

关 键 词：颅内血肿 穿刺术 引流 尿激酶 高血压 脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]