摘要：
Objective The effects of urokinase injection for the treatment of ventricular hemorrhage were explored.Methods A total of 49 cases of ventricular hemorrhage patients were divided into control group and treatment group randomly.Both two groups used lateral ventricular puncture combined with bilateral ventricular drainage.Twenty-four cases of the treatment group were injected into 100 000 IU urokinase (UK) by the lateral ventricle drainage everyday,and then 100 000 IU UK drainage of lumbar cistern were performed after bilateral ventricular drainage.Twenty-five cases of the control group were injected into 20 000 IU UK by the lateral ventricle drainage everyday,and then 20 000 IU UK drainage of lumbar cistern were performed after bilateral ventricular drainage.Results The prognosis was evaluated according activities of daily living.In treatment group eight cases were Level Ⅰ,10 cases were Level Ⅱ,and 3 cases were Level Ⅲ with an efficient rate of 87.5％.While in control group,3 cases were Level Ⅰ,6 cases were Level Ⅱ,and 7 cases of Level Ⅰ with an efficient rate of 64.0％.The effect of the treatment group was much better than that of the control group (P ＜ 0.01).Conclusion By bidirectional injection of urokinase after minimally invasive surgery for the treatment of severe ventricular hemorrhage,large dose urokinase (UK) is safer and more reliable than the conventional dose.It not only can clear the intraventricular and subarachnoid hemorrhage,promote the awaking of patients,and significantly reduce the mortality and morbidity,but also reduce the intracranial infection,hydrocephalus,and cerebral infarction etc.%目的 探讨大剂量尿激酶双向注入治疗重症脑室出血的作用机制.方法 对49例重症脑室出血患者随机分为治疗组与对照组.均采用双侧脑室穿刺联合腰大池置管双向引流,治疗组24例交替每天向侧脑室引流管注入10万U尿激酶,拔除侧脑室引流管后向腰大池引流管内,每天注入10万U尿激酶液化冲洗.对照组25例只交替向侧脑室注入2万U尿激酶,拔除侧脑室引流管后向腰大池引流管内,每天注入2万U尿激酶液化冲洗.结果 根据日常生活活动能力ADL分级进行预后评价.治疗组Ⅰ级8例,Ⅱ级10例,Ⅲ级3例,有效率(87.5％).对照组Ⅰ级3例,Ⅱ级6例,Ⅲ级7例,有效率(64.0％).效果明显好于对照组(P＜0.01).结论 微创术后双向注入尿激酶治疗重症脑室出血中,大剂量尿激酶(UK)较常规剂量,安全可靠,可尽快清除脑室及蛛网膜下腔的积血,促进患者早日清醒,缩短住院日,可显著降低病死率及致残率,减少颅内感染,脑积水、脑梗死等并发症.
