CT引导穿刺联合尿激酶引流治疗高血压脑出血效果比较  

Comparison of the effect of CT-guided puncture combined with urokinase drainage in the treatment of hypertensive cerebral hemorrhage

作　　者：晁先礼 张明 项朝晖 CHAO Xianli;ZHANG Ming;XIANG Zhaohui(Department of Neurosurgery,Xinyi People’s Hospital,Jiangsu Province,Xinyi 221400,China)

机构地区：[1]江苏省新沂市人民医院神经外科,江苏新沂221400

出　　处：《中国医药导报》2023年第35期102-105,共4页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20181149)。

摘　　要：目的 探讨CT引导穿刺联合尿激酶引流治疗高血压脑出血的效果。方法 选取2020年10月至2022年10月江苏省新沂市人民医院接受治疗的高血压脑出血患者90例,采用随机数字表法分为试验组(CT引导穿刺联合尿激酶引流治疗,45例)和对照组(尿激酶引流,45例)。比较两组治疗效果及治疗后1、3、6个月生存率;比较两组治疗前和治疗后3个月血清髓鞘碱性蛋白(MBP)、血清铁蛋白(SF)水平;比较两组手术时间、术中出血量、手术前后血肿情况、术后卧床时间;记录两组并发症的发生情况。结果 两组治疗效果比较,差异无统计学意义(P>0.05);两组治疗后1、3、6个月生存率比较,差异无统计学意义(P>0.05)。治疗后3个月,两组MBP、SF水平均低于治疗前,且试验组低于对照组(P<0.05)。试验组手术时间、术后卧床时间短于对照组,术中出血量低于对照组,手术前后血肿差值大于对照组(P<0.05)。试验组并发症总发生率低于对照组(P<0.05)。结论 CT引导穿刺联合尿激酶引流和单独使用尿激酶引流治疗高血压脑出血效果均较好,但是CT引导穿刺联合尿激酶引流在术后并发症、神经功能康复方面的效果优于单纯尿激酶引流治疗。Objective To investigate the effect of CT-guided puncture combined with urokinase drainage in the treatment of hypertensive cerebral hemorrhage.Methods A total of 90 patients with hypertensive cerebral hemorrhage who received treatment in Xinyi People’s Hospital of Jiangsu Province from October 2020 to October 2022 were selected,and they were divided into experimental group(CT-guided puncture combined with urokinase drainage treatment,45 cases)and control group(urokinase drainage,45 cases)by random number table method.The treatment effect and survival rate of one,three,and six months after treatment were compared between two groups;the levels of serum myelin basic protein(MBP)and serum ferritin(SF)were compared between two groups before treatment and three months after treatment;operation time,intraoperative blood loss,hematoma before and after operation,and postoperative bed time were compared between two groups;the occurrence of complications in two groups was recorded.Results There was no significant difference in treatment effect between two groups(P>0.05);there were no significant differences in survival rates at one,three,and six months after treatment between two groups(P>0.05).At three months after treatment,the levels of MBP and SF in both groups were lower than those before treatment,and experimental group was lower than control group(P<0.05).The operative time and postoperative bed time of experimental group were shorter than those of control group,intraoperative blood loss was lower than that of control group,and the difference of hematoma before and after operation was greater than that of control group(P<0.05).The total incidence of adverse reactions in experimental group was lower than that in control group(P<0.05).Conclusion Both CT-guided puncture combined with urokinase drainage and urokinase drainage alone are effective in the treatment of hypertensive cerebral hemorrhage.CT-guided puncture combined with urokinase drainage is better than urokinase drainage alone in postoperative complications

关 键 词：CT引导穿刺 尿激酶 神经内镜 高血压脑出血 血肿引流 

分 类 号：R743.34[医药卫生—神经病学与精神病学]