高血压脑出血颅骨钻孔尿激酶溶解引流术与小骨窗开颅血肿清除术的疗效比较

The comparison of cranial trephination and drainage with urokinase VS small bone window craniotomy for hypertensive intracerebral hemorrhage

目的探讨颅骨钻孔尿激酶溶解引流术与小骨窗开颅血肿清除术治疗高血压脑出血(HICH)的临床疗效。方法78例HICH患者随机分为观察组与对照组各39例,观察组给予颅骨钻孔尿激酶溶解引流术,对照组给予小骨窗开颅血肿清除术,对比2组患者临床效果。结果观察组手术时间、住院时间显著低于对照组(P<0.01),术后再出血率2组比较差异无统计学意义(P>0.05);观察组治疗有效率为89.7%,显著高于对照组的64.1%(P<0.01);观察组远期良好率为38.5%,显著高于对照组的10.3%(P<0.01)。结论与小骨窗开颅血肿清除术比较,颅骨钻孔尿激酶溶解引流术具有手术时间短、住院时间短、近期远期疗效均较好等优点,值得临床推广。

Objective To compare the clinical effects between cranial trephination and drainage with urokinase and small bone window craniotomy on hypertensive intracerebral hemorrhage（HICH）. Methods Seventy-eight patients with HICH were randomly divided into observation group（n= 39） and control group（n= 39）, the observation group was treated by cranial treph- ination and drainage with urokinase, and the control group received small bone window craniotomy. Then the clinical effects were compared between the two groups. Results The operation time and hospitalization stays in the observation group were sig- nificantly shorter than those in the control group（P〈0.01）, however no significantly difference was found between two groups regarding the incidence of postoperative bleeding（P〉 0.05）. The effective rate in the observation group was 89.7 %, signifi- cantly higher than 64.1% in the control group（P〈0.01）. Additionally,the observation group（38.5%） showed better long- term effective rate than the control group（10.3%） with a significant difference（P〈0.01）. Conclusion Compared with small bone window craniotomy, cranial trephination and drainage with urokinase may have shorter operation time, shorter hospitaliza- tion stays, with better long-term effect, which should be worthy of promotion.