立体定向引导穿刺引流术结合尿激酶治疗中等量高血压脑出血效果观察

摘要

Objective To study the effect of stereotaxic guided puncture and drainage combined with urokinase in the treatment of moderate hypertensive intracerebral hemorrhage.Methods 89 patients with moderate hypertensive intracerebral hemorrhage treated at our hospital from June,2013 to June,2015 were divided into a study group (n=47) and a control group (n=42) randomly.The study group were treated with stereotactic guided puncture and drainage and urokinase and the control group with craniotomy and hematoma evacuation.The hematoma clearance rate,hematoma residual volumes 3 and 7 days after surgery,improvement of neurological function deficit,and postoperative complications were compared between these two groups.Results More patients kept conscious in the study group than in the control group,with a statistical difference (P ＜ 0.05).The scores of neurological function were significantly lower in the study group than in the control group after surgery,with a statistical difference (P ＜ 0.05).1 week after surgery,the hematoma clearance rate was (91.35±10.35) ％ in the study group and was (68.96±9.26) ％ in the control group,with a statistical difference (P ＜ 0.05).The hematoma residual volumes 3 and 7 days after surgery were lower in the study group than in the control group,with statistical differences (P ＜ 0.05).There was a statistical difference in the incidence of postoperative complications between these two groups (P ＜0.05).Conclusions Stereotaxic guided puncture and drainage combined with urokinase in treatment of moderate hypertensive intracerebral hemorrhage can significantly improve the patients' cognition state,rapidly remove hematoma and recover neurological function,and reduce postoperative complications,so it is of reference.%目的 研究中等量高血压脑出血患者采用立体定向引导穿刺引流术联合尿激酶治疗效果.方法 针对2013年6月至2015年6月本院收治入院的中等量(血肿量25～60 ml)高血压脑出血患者89例,按照随机分组原则分为两组;研究组47例患者采用立体定向引导穿刺引流术联合尿激酶,对照组42例患者予以开颅血肿清除术;比较组间意识状态改善、术后1周血肿清除率、术后(3 d、7d)血肿残余量、神经功能缺损改善及术后并发症情况.结果 研究组术后处于清醒状态者所占比例高于对照组,差异具有统计学意义(P＜0.05),术后神经功能评分比较,研究组明显低于对照组,组间差异有统计学意义(P＜0.05);研究组术后1周血肿清除率为(91.35±10.35)％,高于对照组的(68.96±9.26)％,差异有统计学意义(P＜ 0.05),且术后同一时间组间血肿残余量比较,研究组明显较对照组少,差异有统计学意义(P＜0.05);组间术后并发症比较差异有统计学意义(P＜0.05).结论 立体定向引导穿刺引流术结合尿激酶治疗,能够显著改善中等量高血压脑出血患者意识状态,快速清除血肿,恢复神经功能,且术后并发症也较少,值得参考应用.