微创颅内血肿抽吸术联合尿激酶治疗高血压脑出血的临床研究

Clinical Study of Minimally Invasive Intracranial Hematoma Suction Joint of Urokinase in the Treatment of Hypertensive Cerebral Hemorrhage

目的研究微创颅内血肿抽吸术联合尿激酶治疗高血压脑出血的疗效。方法将柳州市柳铁中心医院2009年1月至2012年6月收治的92例高血压脑出血患者根据治疗方法分为两组:观察组(46例)采用微创颅内血肿抽吸术联合尿激酶治疗,对照组(46例)采用小骨窗开颅手术治疗。采用Kamafsky行为能力评分对患者术后1、3、6个月功能恢复情况进行评价,同时采用日常生活能力评分(ADL)评定法评价存活患者生存情况。结果观察组平均意识恢复时间较对照组短(P<0.05),术后1、3、6个月Kamafsky评分显著高于对照组(P<0.05);观察组死亡3例、病死率为6.98%,对照组死亡8例、病死率为17.39%,两组比较差异有统计学意义(P<0.05);观察组ADL1～3的评定28例(65.17%),对照组19例(50%),观察组存活患者的生存质量显著优于对照组,两组比较差异有统计学意义(P<0.05)。结论微创颅内血肿抽吸术联合尿激酶可降低病死率,提高患者生存质量,是治疗高血压脑出血安全有效的方法。

Objective To study the therapeutic effect of minimally invasive intracranial hematoma aspiration combined urokinase treatment of hypertensive cerebral hemorrhage.Methods Chosen from Guangxi Liuzhou Railway Central Hospital during January 2009 and June 2012,92 patients with hypertensive cerebral hemorrhage were grouped according to the treatment method,the 46 patients treated by minimally invasive intracranial hematoma aspiration combined urokinase were observation group,46 patients treated by small bone window craniotomy were control group.Kamafsky score was used to evaluate functional recovery 1,3,6 months after surgery,while ADL score was used to assess the living of the survivals.Results The average awareness recovery time of the observation group was shorter than the control group（P 0.05）;one month,three months,six months after surgery,Kamafsky score was significantly higher than the control group（P 0.05）;in observation group 3 patients died forming a mortality of 6.98%,while in the control group 8 patients died forming a mortality of 17.39%,the difference was of statistical significance（P 0.05）;in the observation group there were 28 cases of ADL1-3,accounting for 65.17%,in the control group there were 19 cases,accounting for 50%;quality of life of the observation group survivals was significantly better than the control group（P 0.05）.Conclusion Minimally invasive intracranial hematoma aspiration joint urokinase can reduce the mortality,improve quality of life of patients,therefore is a safe and effective treatment of hypertensive cerebral hemorrhage.