YL-1型针联合尿激酶注射在治疗中等量基底节区脑出血中的应用

Application of YL-1 needle combined with urokinase injection in the treatment of moderate basal ganglia hemorrhage

目的 探讨YL-1型针钻孔引流术联合尿激酶注射治疗中等量基底节区出血的临床疗效。方法 回顾性分析2013年9月至2021年2月我院收治的48例意识清楚或嗜睡伴有肢体和或言语功能障碍的中等量基底节区高血压脑出血患者(GCS评分12~15分),分别采用YL-1型针钻孔引流术联合尿激酶注射治疗和保守治疗,即手术组和对照组。观察比较两组治疗效果、血肿消除时间、并发症发生率、ADL预后评定等方面的差异。结果 血肿消除时间:治疗组为(7.50±3.6)d,对照组为(21.14±5.7)d,两组比较差异有统计学意义(P <0.05)。并发症发生率:两组肺部感染发生率比较差异无统计学意义(P> 0.05);手术组的手术相关并发症中,气颅发生率为15.4%,颅内感染发生率为3.8%,穿刺道出血发生率3.8%。1个月后ADL预后评定:手术组Ⅰ级5例,Ⅱ级11例,Ⅲ级8例,Ⅳ级2例,Ⅴ级0例;对照组Ⅰ级1例,Ⅱ级4例,Ⅲ级10例;Ⅳ级7例,Ⅴ级0例,两组比较差异有统计学意义(P <0.05)。结论 治疗中等量基底节区高血压脑出血,YL-1型针穿刺引流术具有操作简单、微创、功能恢复时间快、疗效良好等优点。

Objective To explore the clinical efficacy of YL-1 needle trepanation drainage combined with urokinase injection in the treatment of moderate basal ganglia hemorrhage. Methods We retrospectively analyzed 48 patients with moderate basal ganglia hypertensive cerebral hemorrhage(GCS score 12-15)who were conscious or lethargic with limb and/or speech dysfunction in our hospital from September 2013 to February 2021. The patients received either YL-1 needle trepanation drainage combined with urokinase injection(study group)or conservative treatment(control group). Differences in time to hematoma elimination,complication rate,and ADL prognosis were analyzed. Results The time to hematoma elimination was(7.50 ± 3.6)days in the study group and(21.14 ± 5.7)days in the control group,and the difference between the two groups was statistically significant(P < 0.05). There were no statistical differences in the rate of pulmonary infection between the two groups(P > 0.05).Of the procedure-related complications,the incidence was 15.4% for pneumocranium and 3.8% for both intracranial infection and puncture tract bleeding. ADL prognosis assessment one month after the procedure,5 patients were in level Ⅰ,11 in level Ⅱ,8 in level Ⅲ,2 in level Ⅳ,and none in level Ⅴ in the study group;whereas 1 patient in level Ⅰ,4 in level Ⅱ,10 in level Ⅲ,7 in level Ⅳ,and none in level Ⅴ. The difference between the two groups in the number of patients in levels Ⅱ and Ⅳ was statistically significant(P < 0.05). Conclusions For the treatment of moderate hypertensive cerebral hemorrhage in the basal ganglia area,YL-1 needle trepanation drainage has the advantages of simple operation,minimal invasiveness,faster functional recovery,and better curative effect.