尿激酶局部冲洗对慢性硬膜下血肿锥颅引流术后复发的影响  

The effects of local irrigation of urokinase on recurrence of chronic subdural hematoma after cranial cone irrigation and drainage

作　　者：王辉[1] 王东东 王存祖 陈品 于波 闻金坤 易盼 何世维 曾巍 WANG Hui;WANG Dongdong;WANG Cunzu;CHEN Pin;YU Bo;WEN Jinkun;YI Pan;HE Shiwei;ZENG Wei(Northern Jiangsu People's Hospital,Yangzhou 225001,China)

机构地区：[1]大连医科大学,大连116027 [2]苏北人民医院神经外科 [3]扬州大学

出　　处：《中国神经精神疾病杂志》2020年第11期651-655,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨尿激酶局部冲洗对慢性硬膜下血肿锥颅引流术后复发的影响。方法回顾性分析2013年1月至2018年12月经锥颅引流术治疗的慢性硬膜下血肿患者,分为尿激酶组(387例)和无尿激酶组(129例),比较两组术后第1天至拔除引流管前的引流量及术后3个月血肿复发率。结果符合入选标准的患者516例,共进行锥颅引流术610次,其中双侧血肿双侧手术94例,单侧手术41例。术后给予尿激酶冲洗的462例次,术前两组血肿体积差异无统计学意义,术后尿激酶组引流量为(157.3±4.9)mL,无尿激酶组引流量为(133.6±10.2)mL,两组差异有统计学意义(P<0.05)。术后总复发39例(7.6%),其中尿激酶组为29例(6.28%),无尿激酶组为10例(6.76%),两组差异无统计学意义(P>0.05)。结论尿激酶血肿腔内冲洗可以促进慢性硬膜下血肿锥颅引流术后引流,且不会增加术后复发率。Objective To investigate preventive effects of local irrigation of urokinase against recurrence of chronic subdural hematoma after cranial cone irrigation and drainage.Methods A retrospective analysis of patients with chronic subdural hematoma treated with cranial cone irrigation and drainage in neurosurgery of Northern Jiangsu People'Hospital from January 2013 to December 2018.Patients were divided into the urokinase group(387 cases)and the non-urokinase group(129 cases).The drainage volume and recurrence rate of hematoma 3 months after operation were compared between the two groups.Results A total of 516 patients who met the inclusion criteria were enrolled.A total of 610 patients underwent cranial cone irrigation and drainage,including 94 bilateral surgery and 41 unilateral surgery in bilateral hematoma.Four hundred and sixty-two patients were given local irrigation of urokinase after the surgery.There was no significantly statistical difference in pre-operation hematoma volume between the two groups(P>0.05).However.there was significant statistical difference in the drainage volume between urokinase group(157.3±4.9)mL and non-urokinase group(133.6±10.2)mL(P<0.05).Total postoperative recurrence were 39 patients(7.6%).There were 29 cases(6.28%)in the urokinase group and 10 cases(6.76%)in the non-urokinase group.But there was no significant difference between the two groups(P>0.05).Conclusion Urokinase irrigation can promote drainage after cranial cone irrigation and drainage of chronic subdural hematoma,without increasing postoperative recurrence rate.

关 键 词：慢性硬膜下血肿 锥颅引流术 尿激酶 复发 

分 类 号：R651[医药卫生—外科学]