锥颅加尿激酶灌注治疗高血压脑出血46例

Skull-drilling and urokinase perfusion in the treatment of hypertensi ve intracerebral hemorrhage:report of 46 cases

目的探讨锥颅加尿激酶治疗高血压脑出血的临床效果。方法术前CT确定位置,徒手锥颅,置入引流管抽吸血肿,并灌注尿激酶溶解血块。结果46例中6h内手术10例,死亡1例;6￣24h手术24例,死亡5例;1￣3d手术6例,死亡2例;3￣5d手术6例,死亡1例。结论超早期锥颅手术,采用粗口径引流管及大剂量使用尿激酶治疗高血压脑出血有较好疗效。

Objective To discuss the therapeutic effect of skull- drilling and urokinase perfusion in the treatment of hypertensive intracerebral hemorrhage. Methods The hematoma localized with CT before surgery was drai ned and dissolved with urokinase through the pumping duct inserted in the hand-d rilled approach. Results Of the 46 patients, 10 underwent the operation 6 h after hemorrhage, and 1 died; 24 had the operation 6~24 h after hemorrhage, and 5 died; 6 had the operation 1~3 d after hemorrhage, and 2 died; 6 had the opera tion 3~5 d after hemorrhage, and 1 died. Conclusion The large-diameter dra inage duct and large-dose urokinase perfusion can achieve better therapeutic eff ects in the treatment of hypertensive intracerebral hemorrhage, and the operatio n should be as early as possible.