传统开颅与钻孔引流术治疗高血压脑出血后颅内压变化的对比研究

目的 :探讨传统开颅与钻孔引流术加尿激酶溶解术两种治疗方式对高血压脑出血 (HICH)患者颅内压的影响。方法 :112例 HICH患者随机分为两组 ,分别采用传统开颅术和钻孔引流术及尿激酶溶解术治疗。60例患者采用传统开颅术 ,5 2例采用钻孔引流术及尿激酶治疗 ;同时在出血对侧行侧脑室置管 ,监测侧脑室颅内压 (ICP) ;采集术后即刻、2 4h、72 h和 1周的 ICP值 ,并进行统计分析。结果 :虽然传统开颅组与钻孔引流术和尿激酶溶解术组均有 ICP的增高 ,但传统开颅组 ICP增高幅度明显低于钻孔引流术组 ,两组患者的 ICP对比有显著差异 (P<0 .0 5或 P<0 .0 1)。结论 :在降低 ICP方面传统开颅术明显优于钻孔引流术加尿激酶溶解术

Comparison of the intracranial pressure value in patients with hypertensive intracerebral hemorrhage treated with traditional craniotomy and puncture drainage

Objective: To compare the difference of intracranial pressure (ICP) in patients with hypert ensive intracerebral hemorrhage (HICH) treated with two surgical procedures, tra ditional craniotomy and puncture drainage. Methods: One hund red and twelve cases with HICH were randomly divided into two groups. In one gro up, 60 patients were operated by traditional craniotomy and in an other group, 52 cases by puncture drainage and urokinase treatment. In the me antime, ICP was monitored by placing catheter in lateral ventricle on the contralateral side of the hemor rhage. ICP values were recorded after operation at once, at 24 hours, 72 hou rs and 1 week. Results: Although all the patients showed increased ICP, the increasing degree in patient s treated with traditional craniotomy had lower ICP values(P<0 05 or P<0 01). Conclusion: Traditional craniotomy has advantages over puncture drainage for patients wi th HICH at least w ith respect to decreasing ICP.