纤溶治疗方法应用于老年高血压脑出血破入脑室的临床研究

Fibrinolysis treatment for hypertensive intracranial hemorrhage with intraventricular hematoma in aged patients

目的探究纤溶治疗方法应用于老年高血压脑出血破入脑室患者的安全性以及有效性。方法在接受纤溶治疗的高血压脑出血破入脑室患者中,选择12例老年患者作为老年组,22例非老年患者作为对照组。对比两组基本情况(收缩压最高值、血肿量、术前GCS评分、预后评分等)以及治疗后观察指标(住院天数、血肿清除率、GCS评分改善、再出血例数、术后6个月的mRS评分及GOS-E评分等)。结果老年组的预后评分较差(P<0.05),糖尿患者也较对照组多(P<0.01)。接受尿激酶纤溶治疗后,老年组治疗后观察指标与对照组无明显统计学差异。老年患者中,接受血肿清除的患者出血量高于单纯脑室外引流组(P<0.05),且预后评分较低(P<0.05),但血肿清除组及单纯脑室外引流组的治疗后观察指标无明显统计学差异。结论纤溶治疗应用于老年高血压脑出血破入脑室患者具有安全性及有效性;开颅血肿清除术不会影响尿激酶纤溶治疗的安全性及有效性,且对于出血量较大的老年高血压脑出血破入脑室患者,建议使用血肿清除联合尿激酶纤溶治疗。

Objective To investigate the safety and efficacy of fibrinolysis treatment for hypertensive intracranial hem- orrhage （HICH） with intraventricular hematoma （IVH） in aged patients. Methods 34 patients with HICH and IVH received fibrinolysis treatment, including 12 aged patients and 22 younger patients. The pretreatment parameters （including SBP, hematomavolume, pre-opGCS, prognosis score, etc.） and theposttreatment （including length of stay, hematoma clearance ratio, rehemorrhage, 6 months mRS score and GOS-E score, etc.） were compared between both groups. Results Compared to the younger group, the aged group had worse prognosis （P〈0.05） and more diabetes （P〈0.01）. There was no difference in post-treatment data of the two groups after fibrinolysis. Conclusions The fibrinolysis treatment is safe and effective for hypertensive intracranial hemorrhage with intraventricular hematoma in aged oatients.