钻孔引流微创联合术后尿激酶溶解治疗高血压脑出血效果研究.docVIP

钻孔引流微创联合术后尿激酶溶解治疗高血压脑出血效果研究 　　[摘要] 目的 研究和分析钻孔引流微创联合术后尿激酶溶解治疗的可行性和价值。方法 随机抽取于2014年1月―2015年1月，来该院神经外科住院治疗高血压脑出血患者120例作为研究对象并分组研究，其中观察组60例患者治疗上给予钻孔引流微创联合术后尿激酶溶解治疗，而对照组60例患者治疗上给予开颅骨瓣血肿清除术治疗，对比和分析两组患者的临床治疗效果。结果 观察组总有效率为58（96.67%），对照组总有效率为48（80.00%），观察组患者的临床治疗效果比对照组更占据优势，并比较差异具有统计学意义（χ2=6.14，P0.05）。结论 采取钻孔引流微创联合术后尿激酶溶解的方法对高血压脑出血患者治疗，疗效显著，有且有利于术后患者的恢复，值得临床推广。 　　[关键词] 高血压脑出血；钻孔引流；尿激酶；临床疗效 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-0742（2015）11（b）-0108-03 　　[Abstract] Objective To study and analyze the feasibility and value of minimally invasive drilling drainage combined with urokinase clot lysis for treatment of hypertensive cerebral hemorrhage. Methods 120 patients with hypertensive cerebral hemorrhage hospitalized in the department of neurosurgery in this hospital from January 2014 and January 2015 were randomly selected as the research object. 60 of them in the observation group were treated with minimally invasive drilling drainage combined with urokinase clot lysis， while the other 60 in the control group underwent clearance of hematoma by craniotomy with bone flap. The clinical analysis of the patients was analyzed and compared between the two groups. Results The total effective rate [58（96.67%）vs 48（80.00%）] was higher in the observation group than in the control group， and the difference was statistically significant（χ2=6.14， P0.05）. Conclusion Minimally invasive drilling drainage combined with urokinase clot lysis in the treatment of patients with hypertensive cerebral hemorrhage can bring remarkable effect and is conducive to their postoperative rehabilitation. Therefore this method is worthy of promotion. 　　[Key words] Hypertensive cerebral hemorrhage； Drainage； Urokinase； Treatment outcome 　　近年来统计数据显示，我国高血压的发病率越来越高，其并发症的发生率也开始呈上升趋势[1-2]。高血压脑出血和患者日常血压控制不稳密切相关，属于患者脑部血管爆裂形成的血肿压迫局部组织的一种自发性的疾病[3]。随着临床对高血压脑出血认识的加深和各种治疗手段的提高，微创钻孔引流引起创伤小、操作简单而受到各级临床医师的广泛关注，和传统的开颅骨瓣血肿清除术相比更容易得到患者及家属的支持[4]。该院神经外科对120例在2014年1月―2015年1月来该院神经外科住院治疗的高血压脑出血患者，采取不同的治疗方法，取得一定的研究结果，现报道如下。 　　1