肾上腺素对颅内微创血肿清除术患者的影响

目的探讨肾上腺素对颅内微创血肿清除术后的影响。方法对86例基底节区脑出血行微创血肿清除术,术后随机分成两组。A组使用尿激酶加肾上腺素液化血肿,B组予常规尿激酶液化血肿。将两组治疗结果进行临床对比。结果 A组43例中,恢复良好生活能自理27例(62.79%),部分生活自理中残10例(23.26%),重残4例(9.30%),死亡2例(4.65%)。B组43例中恢复良好生活能自理的22例(51.16%),部分生活自理中残12例(27.91%),重残5例(11.63%),死亡4例(9.30%)。术后第1天复查头颅CT,血肿体积A组明显比B组小;两组术后血肿体积及神经功能评分存在显著性差异(P<0.05)。结论颅内微创血肿清除术后尿激酶加肾上腺素液化血肿,治疗效果明显优于常规尿激酶液化血肿。肾上腺素对于颅内血肿有明显收缩血管、止血、防止血肿因尿激酶溶解血块后继发性出血作用。

Influence of Adrenaline on Patients with Microinvasive Evacuation of Intracranial Hematoma

Objective To study the influence of adrenaline on postoperative patients with microinvasive evacuation of intracranial hematoma. Methods Eighty-six cases of basal ganglion hemorrhage treated by microinvasive evacuation were randomly divided into the group A and B after operation. The group A was given urokinase and adrenaline for liquefying hematoma and the group B routinely used uroki-nase for liquefying hematoma. Then the clinical curative effects were evaluated and compared between the two groups. Results Among 43 cases in the group A, 27 cases （62.79%） recovered well with self care ability, 10 cases （23.26%） were mildly disabled with par- tial self care ability, 4 cases（9.30% ） were seriously disabled and 2 cases （4. 65% ） died. Among 43 cases in the group B, 22 cases （51. 16% ） recovered well with self care ability, 12 cases （27.91%） were mildly disabled with partial self care ability, 5 cases （ll.63%） were seriously disabled and 4 cases（9.30% ） died. The postoperative 1 d hematoma volume revealed by the head CT reex- amination in the group A was obviously smaller than that in the group B. The significant difference existed in the scores of hematoma volume and the nerves function evaluation between the two groups with statistical significance（ P 〈 0.05）. Conclusion After microinva- sire evacuation of intracranial hematoma, urokinase plus adrenaline for liquefying hematoma has better curative effect than routine uroki-nase. Adrenaline has obvious vascular contraction and hemostasis action in intracranial hematoma, and prevents secondary hemorrhage after urokinase dissolving clots.