微创锥颅血肿碎吸+对侧脑室外引流结合术后血肿腔尿激酶注入与开颅血肿清除术疗效观察  

Observation on the curative effect of minimally invasive taperhead hematoma aspiration+contralateral ventricular drainage combined with postoperative hematoma luminal urokinase injection and craniotomy hematoma removal

作　　者：顾涤恒 王建[1] 金科 陆惠新[1] 高甜甜[1] 钱耀华 申华龙 Gu Diheng;Wang Jian;Jin Ke;Lu Huixin;Gao Tiantian;Qian Yaohua;Shen Hualong(Taicang Traditional Chinese Medicine Hospital,Suzhou,Jiangsu 215400,China)

机构地区：[1]江苏省太仓市中医医院,江苏苏州215400

出　　处：《首都食品与医药》2024年第22期43-46,共4页Capital Food Medicine

基　　金：定向软通道微创手术治疗高血压脑出血的临床研究(编号:TC2021JCYL24)。

摘　　要：目的 研究高血压脑出血患者行微创锥颅血肿碎吸+对侧脑室外引流结合术后血肿腔尿激酶注入与传统开颅血肿清除术的疗效差异.方法 选取我院2017年1月-2023年1月52例高血压脑出血患者,其中31例行微创血肿清除结合术后血肿腔尿激酶注入结合对侧脑室外引流术,21例行常规开颅血肿清除术.前者为实验组,后者为对照组,术后观察患者的动态颅内压监护值、血清NSE与TNF-α值及术后GCS评分情况.结果 两组患者术后颅内压监护值无明显差异(P>0.05),NSE和TNF-α值在术后第3天和术后第5天出现显著差异(P<0.05),术后第7天差异减少,GCS评分有显著差异(P<0.05).结论 微创血肿清除+对侧脑室外引流结合术后血肿腔尿激酶注入与传统开颅血肿清除术相比,手术创伤小、时间短,且术后疗效更优,值得在临床上推广.Objective To evaluate the efficacy of minimally invasive hematoma aspiration+contralateral ventricular drainage combined with postoperative hematoma luminal urokinase injection and traditional craniotomy hematoma removal in patients with hypertensive intracerebral hemorrhage.Methods From January 2017 to January 2023,52 patients with hypertensive intracerebral hemorrhage in our hospital were selected.Among them,31 underwent minimally invasive hematoma removal combined with postoperative hematoma lumen urokinase injection combined with contralateral ventricular drainage,and 21 underwent routine craniotomy hematoma removal.The former was the experimental group,while the latter was the control group.Dynamic intracranial pressure monitoring values,serum NSE and TNF-αvalues,and postoperative GCS score were observed.Results There was no significant difference in postoperative intracranial pressure monitoring between the two groups(P>0.05),but there was significant difference in NSE and TNF-αvalues on day 3 and 5(P<0.05),and the difference was reduced on day 7,GCS score had significant difference(P<0.05).Conc lusion Compared with traditional craniotomy hematoma removal surgery,minimally invasive hematoma removal combined with contralateral ventricular drainage and postoperative injection of urokinase into the hematoma cavity results in less surgical trauma,shorter time,and significantly better postoperative efficacy,which is worthy of clinical promotion.

关 键 词：微创锥颅血肿碎吸 尿激酶 开颅血肿清除 疗效观察 

分 类 号：R743.34[医药卫生—神经病学与精神病学]