慢性硬膜下血肿钻孔引流+尿激酶溶解块状血肿的临床研究

目的探讨慢性硬膜下血肿钻孔引流+尿激酶溶解块状血肿的临床疗效。方法选取2017年3月至2019年6月我院收治的80例慢性硬膜下血肿患者,随机分为A组、B组、C组、D组四组,各20例。A组术后不注射尿激酶,B组术后给予尿激酶2万U+生理盐水5 mL灌注,C组术后给予尿激酶5万U+生理盐水5 m L灌注,D组术后给予尿激酶10万U+生理盐水5 mL灌注。随访观察1个月,比较各组的治疗效果。结果四组患者治疗48 h的血肿清除效果、住院时间、颅内感染率及血肿复发率比较,差异均有统计学意义(P<0.05)。B、C、D组的达到基本清除所需给药次数比较,差异有统计学意义(P<0.05)。结论钻孔引流+尿激酶溶解块状血肿能够有效改善慢性硬膜下血肿患者的临床症状,大幅提高血肿吸收程度,具有较好的临床疗效;尿激酶5万U+生理盐水5 mL灌注方案在疗效显著的同时,给药次数最少,住院时间最短,颅内感染率及血肿复发率均最低,值得推广应用。

Clinical Study on Drilling Drainage Combined with Urokinase Dissolving Massive Hematoma for Chronic Subdural Hematoma

Objective To explore the clinical efficacy of drilling drainage combined with urokinase dissolving massive hematoma for chronic subdural hematoma.Methods 80 patients with chronic subdural hematoma admitted to our hospital from March 2017 to June 2019 were selected and randomly divided into four groups,with 20 cases in each group.In group A,urokinase was not injected postoperatively.In group B,urokinase 20000 U+5 m L normal saline were perfused postoperatively.In group C,urokinase 50000 U+5 m L normal saline were perfused postoperatively.In group D,urokinase 100000 U+5 m L normal saline were perfused postoperatively.Each group was followed up for one month,and the curative effects were compared.Results There were significant differences in hematoma clearance effect 48 h after treatment,hospitalization time,intracranial infection rate and hematoma recurrence rate among the four groups(P<0.05).There was significant difference in the times of administration required to achieve basic clearance among group B,group C and group D(P<0.05).Conclusions Drilling drainage combined with urokinase dissolving massive hematoma can effectively improve the clinical symptoms of patients with chronic subdural hematoma,greatly improve the absorption degree of hematoma,with good clinical efficacy.Urokinase 50000 U+normal saline 5 m L perfusion scheme has significant curative effect,with the least times of administration,the shortest time of hospitalization,the lowest rates of intracranial infection and recurrence of hematoma,which is worthy of promotion and application.