低浓度大剂量尿激酶治疗脑室出血的疗效  

Efficacy of urokinase in high-dose and low concentration for the treatment of intraventricular hemorrhage

作　　者：李民[1] 周鹏[1] 张亮[1] 戴学东[1] 王东[1] LI Min;ZHOU Peng;ZHANG Liang(Deparment of Neurosurgery,Nanjing Jiangning Hospital,Nanjing 211100,CHINA)

机构地区：[1]南京市江宁医院神经外科,江苏211100

出　　处：《江苏医药》2021年第7期681-683,共3页Jiangsu Medical Journal

基　　金：江苏省卫生健康委员会指导性课题(Z2017005)。

摘　　要：目的探讨双侧侧脑室引流加低浓度大剂量尿激酶对脑室出血的治疗效果。方法60例脑室出血患者均分为试验组及对照组,均采用双侧侧脑室外引流术和侧脑室清除血肿后注射尿激酶10万U;试验组的尿激酶以生理盐水10 mL溶解,对照组的尿激酶以生理盐水5 mL溶解。比较两组治疗前及治疗后1周血肿吸收时间、闭管天数、脑脊液持续引流时间等指标。结果试验组血肿吸收时间[(5.7±1.4) d]、闭管天数[(8.0±1.3) d]和脑脊液持续引流时间[(12.7±1.5) d]均短于对照组[(6.1±2.3) d、(9.2±2.2) d和(14.6±2.9) d](P<0.05)。治疗后试验组中枢性发热2例,死亡1例;对照组出现再次出血2例,中枢性发热5例,死亡3例;试验组并发症发生率低于对照组(10.0%vs.33.3%)(P<0.05)。结论低浓度大剂量尿激酶对治疗脑室出血效果明显,可改善患者生命体征,有效清除脑室内血肿,降低颅内感染的发生率。Objective To observe the efficacy of bilateral ventricular drainage with high-dose and low concentration urokinase in the treatment of intraventricular hemorrhage.Methods A total of 60 patients with ventricular hemorrhage patients was divided into two groups and treated with bilateral ventricular drainage and an injection of urokinase 1×10^(5) U in 10 mL normal saline(group A,30 cases) or in 5 mL normal saline(group B,30 cases) into the side brain ventricle after hematoma removal.The hematoma removal time, close tumb and the duration of cerebrospinal fluid drainage before and one week after treatment were compared between the two groups.Results Compared to group B,group A had shorter hematoma removal time [(5.7±1.4)days vs.(6.1±2.3)days],close tumb [(8.0±1.3) days vs.(9.2±2.2) days] and duration of cerebrospinal fluid drainage [(12.7±1.5) days vs.(14.6±2.9) days](P<0.05).There were 2 cases with central fever and 1 case of death in group A.There were 2 cases with renew bleeding, 5 cases with central fever and and 3 cases of death in group B.The incidence of complications was statistically lower in group A than that in group B(10.0% vs.33.3%)(P<0.05).Conclusion Compared to an injection of urokinase 1×10^(5) U in 5 mL normal saline into the side brain ventricle after hematoma removal for the treatment of intraventricular hemorrhage, an injection of urokinase 1×10^(5) U in 10 mL normal saline is better in effectively improving the vital signs of patients and removal of intraventricular hematoma, and reducing the incidence of intracranial infection.

关 键 词：侧脑室引流 尿激酶 脑室出血 

分 类 号：R651[医药卫生—外科学]