微创颅内血肿清除术联合术后尿激酶溶解治疗基底核区高血压脑出血的效果及对神经功能、预后的影响研究  

Effect of Minimally Invasive Removal of Intracranial Hematoma Combined with Urokinase Lysis on Hypertensive Intracerebral Hemorrhage in Basal Ganglia and Its Influence on Neurological Function and Prognosis

作　　者：李少泉[1] 彭文龙 张维 白丽梅[1] 郑志霞 于金然 LI Shao-quan;PENG Wen-long;ZHANG Wei;BAI Li-mei;ZHENG zhi-xia;YU Jin-ran(Department of Neurosurgery,Central Hospital of Cangzhou,Cangzhou,Hebei 061001,China;Department of Neurosurgery,Botou Hospital of Hebei Province,Botou,Hebei 062150,China;Department of Neurosurgery,People's Hospital of Cangzhou,Cangzhou,Hebei 061001,China)

机构地区：[1]沧州市中心医院神经外科,河北沧州061001 [2]泊头市医院神经外科,河北泊头062150 [3]沧州市人民医院神经外科,河北沧州061001

出　　处：《解放军医药杂志》2020年第11期89-93,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省医学科学研究重点课题计划项目(20191252)。

摘　　要：目的探讨微创颅内血肿清除术联合术后尿激酶溶解治疗基底核区高血压脑出血(HICH)的效果及对神经功能、预后的影响。方法选取2016年4月-2018年4月我院收治的80例基底核区HICH患者为研究对象,根据治疗方法分为观察组和对照组,每组40例。观察组采用微创颅内血肿清除术联合术后尿激酶溶解治疗,对照组采用传统开颅血肿清除去骨瓣减压术治疗。比较2组临床疗效,治疗前及治疗后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数及并发症发生情况。结果观察组总有效率高于对照组(P<0.05);2组治疗后NIHSS评分、Barthel指数均改善,且观察组改善程度显著优于对照组(P<0.05);观察组治疗后并发症发生率低于对照组(P<0.05)。结论微创颅内血肿清除术联合术后尿激酶溶解治疗基底核区HICH可提高临床疗效,有利于患者神经功能、日常生活能力恢复,且治疗安全性较好。Objective To investigate the effect of minimally invasive removal of intracranial hematoma combined with urokinase lysis on hypertensive cerebral hemorrhage(HCH)in basal ganglia and its influence on neurological function and prognosis.Methods Eighty patients with HICH in basal ganglia region treated in our hospital from April 2016 to April 2018 were selected as the research subjects.According to the treatment methods,they were divided into observation group(n=40)and control group(n=40).The observation group was treated with minimally invasive removal of intracranial hematoma combined with postoperative urokinase lysis,while the control group was treated with traditional craniotomy hematoma removal and bone flap decompression.The clinical efficacy,NIHSS score,Barthel index and complications were compared between the two groups before and after treatment.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The NIHSS score and Barthel index of the two groups were improved,and the improvement degree of the observation group was significantly better than that of the control group(P<0.05).The total complication rate of the observation group was lower than that of the control group(P<0.05).Conclusion Minimally invasive removal of intracranial hematoma combined with urokinase lysis can improve the clinical effect of HICH in the basal ganglia,which is beneficial to the recovery of neurological function and daily living ability of patients,and the treatment is safe.

关 键 词：颅内出血 高血压性 基底核区 颅内血肿清除术 尿激酶 手术后并发症 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]