高血压脑出血微创术后超早期应用尿激酶的临床疗效分析

Therapeutic Effect of Minimally Invasive Evacuation of Intracranial Hematoma in Combination with Urokinase at Ultra-early Phase on Patients with Hypertensive Intracerebral Hemorrhage

目的:分析微创血肿清除术后超早期应用尿激酶治疗高血压脑出血的临床疗效。方法:接受微创血肿清除术治疗的高血压脑出血患者65例,根据尿激酶开始使用的时间分为早期组32例(血肿腔注入尿激酶开始时间<6h),对照组33例(血肿腔注入尿激酶开始时间≥6h),随访6个月;比较2组住院时间、入住NICU时间、再出血率、病死率、中国脑卒中临床神经功能缺损程度评分量表(CSS)评分及Barthel指数(BI)。结果:早期组住院时间、入住NICU时间、再出血率及病死率均少于对照组(P<0.05);治疗后,早期组CSS评分与BI均高于治疗前(P<0.05);对照组CSS评分与治疗前差异无统计学意义,BI高于治疗前(P<0.05);治疗后,早期组CSS评分及BI均高于对照组(P<0.05)。结论:高血压脑出血微创血肿清除术后超早期应用尿激酶治疗高血压脑出血安全、有效。

Objective： To investigate the therapeutic effect of ultra-early administration of urokinase on patients with hypertensive intracerebral hemorrhage （HICH） after minimally inva- sive evacuation of intracranial hematoma. Methods： Sixty-five patients with HICH treated with minimally invasive evacuation were divided into group A （urokinase was applied within 6 h post- onset,n：32） and group ]3 （urokinase was applied after 6 h post-onset,n：33）. The lengths of hospitalization and NICU stay, rate of rebleeding, fatality, scores of China Stroke Scale （CSS） and barthel index （BI） after 6 months follow-up were documented and compared between the two groups. Results： The lengths of hospitalization and NICU stay, the rate of rebleeding, and fatal- ity in the group A were significantly lower than those in the group B （P〈0.05）. The scores of CSS and BI in the group A were significantly improved after treatment when compared with those before the treatment （P〈0.05）. No difference of CSS score was found before and after the treat- ment in the group B, whereas BI was much improved after the treatment （P〈0.05）. Both the scores of CSS and BI in the group A were higher than those in the group B （P〈0.05） after 6 months. Conclusion： It is safe and effective to apply urokinase at ultra-early stage on patients with HICH after minimally invasive evacuation.