不同剂量尿激酶治疗脑室出血的临床效果比较

Comparison of clinical effects of different doses of urokinase in the treatment of ventricular hemorrhage

目的比较不同剂量尿激酶治疗脑室出血的疗效。方法将2010年1月-2016年4月该院收治的80例脑室出血患者随机分为尿激酶2万U组、4万U组、6万U组、10万U组各20例,分别给予尿激酶2万U、4万U、6万U、10万U均加入生理盐水5ml灌注,2次/d治疗。手术前后每天利用CT自带CAD软件测量4组患者的脑室内血肿量、每天血肿排出量及血肿大部分排出所需时间。结果 4组患者术前血肿体积无显著性差异(P>0.05)。随着尿激酶量的加大,每天血肿排出量逐渐加大,血肿大部分排出所需时间减少。术后尿激酶4万U组、6万U组、10万U组每天血肿排出量均大于尿激酶2万U组,血肿大部分排出所需时间均小于尿激酶2万U组,差异均有统计学意义(P<0.05)。术后尿激酶6万U组、10万U组每天血肿排出量均大于尿激酶4万U组,血肿大部分排出所需时间均小于尿激酶4万U组,差异均有统计学意义(P<0.05)。但尿激酶6万U组与10万U组间每天血肿排出量、血肿大部分排出所需时间比较差异无统计学意义(P>0.05)。结论尿激酶6万U+生理盐水5ml灌注,2次/d治疗脑室出血可明显缩短血肿廓清时间。

Objective To compare the clinical effects of different doses of urokinase in the treatment of ventricular hemorrhage. Methods 80 patients with ventricular hemorrhage,selected in the hospital from January 2010 to April 2016,were randomly divided into four groups,each of 20 cases. Four groups were treated with four different doses of urokinas( 20 000 U,40 000 U,60 000 U,10 0000U) respectively after operation. Measured the intraventricular hematoma volume,hematoma discharge per day and most of the hematoma discharged time of four groups. Results Before operation,there was no significant difference in the volume of hematoma between the four groups( P > 0. 05). With the increase in the amount of urokinase,daily hematoma discharge volume gradually increased,most of the hematoma discharge time reduced. The amount of hematoma discharged per day of urokinase 40 000 U group,60 000 U group,100 000 U group were greater than that of urokinase 20 000 U group,and the most hematoma discharge time were shorter than that of urokinase 20 000 U group,the differences were statistically significant( P < 0. 05). The hematoma volume per day of urokinase 60 000 U group,100 000 U group were significantly higher than that of urokinase 40 000 U group,the most hematoma discharge time were shorter than that of urokinase 40 000 U group,the differences were statistically significant( P < 0. 05). However,there was no significant difference in hematoma volume per day and the most hematoma discharge time between urokinase 60 000 U group and 10 000 U group( P > 0. 05). Conclusion60 000 U urokinas can significantly shorten the time of hematoma clearance and reduce the complications in treatment of ventricular hemorrhage. It's a reliable treatment for ventricular hemorrhage.