大剂量尿激酶注入脑室治疗重度原发性脑室出血的效果

Effects of high-dose urokinase intraventricular injection in treatment of serious ventricular hemorrhage

目的：探讨大剂量尿激酶注入脑室治疗重度原发性脑室出血的效果。方法将65例重度原发性脑室出血患者随机分为治疗组（33例）与对照组（32例）。两组均采用双侧脑室穿刺置管引流，治疗组患者每天侧脑室注入尿激酶10万IU，对照组患者侧脑室注入尿激酶2万IU，连续3～7 d。两组患者在侧脑室引流管拔除后均行腰大池置管引流。治疗后每天行头颅CT检查，观察脑室血肿的变化；并观察颅内感染、脑积水发生的状况。结果治疗组脑室血肿消失及侧脑室、腰大池置管引流时间均明显短于对照组（均P＜0．01）。治疗组无1例出现脑积水及颅内感染，对照组出现脑积水7例（21．8％）、颅内感染8例（25．0％），两组比较，差异有统计学意义（均P＜0．01）。结论大剂量尿激酶注入脑室治疗重度原发性脑室出血有显著效果，可迅速清除脑室积血，缩短脑室、腰大池置管引流时间，减少颅内感染和脑积水等并发症。

Objective To explore the effects of high-dose urokinase （ UK ） injection for the treatment of ventricular hemorrhage .Method A total 65 cases of ventricular hemorrhage patients were divided into control group and treatment group randomly .100,000 IU urokinase were injected into lateral ventricular after bilateral external ventricular drainage in treatment group for 3-7 days.20,000 IU urokinase were injected into lateral ventricular after external bilateral ventricular drainage in control group for 3-7 days.And then lumbar drain were performed after bilateral ventricular drainage in both groups .During the treatment , we checked CT everyday to explore the ventricular hematoma.Besides, exploring the condition of intracranial infection and hydrocephalus .Results In treatment group, the time of ventricular hematoma elimination was shorter than control group .Besides, the time of bilateral ventricular drainage and drainage of lumbar cistern were also shorter .There were no intracranial infection and hydrocephalus in treatment group , but 7 cases of intracranial infection and 8 cases of hydrocephalus in control group .The result was statistical significance .Conclusion Compared with control group , ventricular injection of high-dose urokinase is helpful for the hematoma elimination , intracranial infection and hydrocephalus .As well as reducing the time of bilateral ventricular drainage lumbar cistern drainage .