微创大剂量尿激酶治疗脑室出血90例临床分析

High-dose urokinase via minimally invasive approach for the treatment of 90 cases of ventricular hemorrhage

目的分析微创大剂量尿激酶对脑室出血的临床治疗作用。方法 90例脑室出血患者随机分为治疗组和对照组,对照组:脑室外引流术后侧脑室注入尿激酶+腰大池引流术;治疗组:脑室外引流术后侧脑室注入尿激酶+腰大池引流术后经引流管注入尿激酶。结果治疗组腰大池置管持续引流平均时间为6 d,脑室内血肿消失时间平均为(5±1.47)d。对照组腰大池置管持续引流平均时间为12 d,脑室内血肿消失时间平均为(11±3.76)d。结论较单纯腰大池置管引流,微创超大剂量尿激酶双向治疗重度脑室出血,能显著加快脑室血肿溶解,提高生存率。

Objective To analyze the clinical effect of high-dose urokinase via minimally invasive approach for the treatment of ventricular hemorrhage. Methods A total of 90 cases of ventricular hemorrhage were divided into control group and treatment group randomly. Lateral ventricular injection of urokinase after external ventficular drainage plus drainage of lumbar cistern were performed in control group, and lateral ventrieular injection of urokinase after external ventricular drainage plus drainage of lumbar cistem with injection of urokinase were performed in treatment group. Results In treatment group, the time of lumbar cistern drainage was 6 d in average, and the time of ventricular henmtoma elimination was （5 ±1.47） d. In control group,the average time of lumbar cistern drainage was 12 d and the time of ventricular hermtoma elimination was （11 ±3.76） d. Conclusion Compared with control group, ventricular injection of urokinase after external ventricular drainage plus lumbar cistern injection of urokinase are helpful for the hermtoma elimination and increase of survival rate.