微创穿刺与小骨窗开颅治疗高血压脑出血疗效评价

目的 比较微创穿刺血肿抽吸术联合尿激酶与小骨窗开颅血肿清除术治疗高血压脑出血(Hypertensive Cerebral Hemorrhage,HICH)的疗效.方法 入选病人根据随机原则分成A、B两组,并取得患者或其家属同意,A组使用YL-1进行微创穿刺治疗高血压脑出血,术后联合使用尿激酶2万U,每天1次血肿腔内给药,并持续引流;B组采用小骨窗开颅血肿清除术清除血肿.结果 两组患者NIHSS评分和3个月预后GOS评分的差异均无统计学意义,微创穿刺组住院时间短于小骨窗开颅组,差异有统计学意义(P＜0.05);肺部感染率A组低于B组(P＜0.05).结论 微创血肿穿刺抽吸引流术联合尿激酶治疗高血压脑出血,具有操作简便、住院时间短、并发症少的优点,值得在各基层医院推广应用.

The curative effect of minimally invasive treatment and small bone window craniotomy of hypertensive cerebral hemorrhage

Objective To compare the curative effect of minimally invasive treatment of hematoma aspiration combined urokinase therapy and the small bone window hematoma evacuation for hypertensive cerebral hemorrhage.Methods The selected patients which were permitted by their families were randomly divided into two groups.Group A was used the YL-1 hematoma puncture needle for minimally invasive treatment of hypertensive cerebral hemorrhage,after the operation twenty-thousand units of urokinase was administrated into hematoma cavity daily.Group B was taked hematoma evacuation with a small bone window in order to remove the hematoma.Results There was no significant difference in the NIHSS score and 3-month outcome on the GOS score,but minimally invasive was with less trauma,shorter hospital stay,fewer the incidence of pulmonary infection compared with the craniotomy group(P<0.05).Conclusion The treatment of minimally invasive and thencombined urokinase therapy for intracalvarium hematoma with the advantage of technica easy,shorter hospital stay and less symptoms.It is worthy generalization in community-based hospitals.