微创手术加尿激酶与自体血清治疗亚急性硬膜下硬膜外及慢性硬膜外血肿临床研究.docVIP

微创手术加尿激酶与自体血清治疗亚急性硬膜下硬膜外及慢性硬膜外血肿临床研究 　　[摘要] 目的：探讨微创手术加尿激酶和自体血清对亚急性硬膜下、硬膜外及慢性硬膜外血肿的疗效。方法：对不开颅手术的亚急性硬膜下、硬膜外和慢性硬膜外血肿行局麻或局麻加基础麻醉行锥颅钻孔或钻孔引流，硬膜下血肿术后加尿激酶2万~3万U和自体血清4~6 ml，硬膜外血肿术后即用尿激酶4万~6万U加自体血清5 ml。结果：本组86例均痊愈出院，出院时CT检查血肿完全消失72例，残留少量薄层血肿14例，术后随访6~12个月，无一例复发。结论：微创手术加尿激酶和自体血清对不开颅手术的亚急性硬膜下、硬膜外及慢性硬膜外血肿疗效肯定，值得推广应用。 　　[关键词] 亚急性硬膜下血肿；慢性硬膜外血肿；微创手术；尿激酶；自体血清 　　[中图分类号] R722.14+3[文献标识码]A [文章编号]1673-7210（2009）06（b）-021-02 　　 　　Clinical research of mini-damage surgery plus Urokinase and autoserum for the treatment of sub-acute subdural hematoma, extradural hematoma and chronic extradural hematoma 　　REN Daobin, DING Changyun, Tao Yuchuan 　　(Department of Surgery, the Peoples Hospital of Jiangan County, Sichuan Province, Jiangan644200, China) 　　[Abstract] Objective: To investigate the effects of mini-damage surgery plus Urokinase and autoserum for the treatment of sub-acute subdural, extradural hematoma and chronic extradural hematoma. Methods: 86 cases of sub-acute subdural hematoma, extradural hematoma and chronic extradural hematoma were treated by drilling a hole for drainage through local anesthesia plus basal anesthesia without craniotomy. 20-30 thousands units Urokinase and 4-6 ml autoserum were injected into drainage tube in subdural hematoma patients, and 40-60 thousands units Urokinase and 5 ml autoserum were injected into extradural hematoma patients. Results: All the 86 caseswere discharged with complete recovery. The hematomas completely disappeared in 72 cases and with only a thin edge of hematoma in 14 cases. No one relapsed after 6-12 months follow-up. Conclusion: Mini-damage surgery plus Urokinase and autoserum for the treatment of sub-acute subdural and extradural hematoma and chronic extradural hematoma is an effective method, which is worth popularizing. 　　[Key words] Sub-acute subdural hematoma; Chronic extradural hematoma; Mini-damage surgery; Urokinase; Autoserum 　　 　　亚急性硬膜下、硬膜外和慢性硬膜外血肿是颅脑损伤中的一种常见病和多发病，目前临床上在治疗方面尚无一种统一的方法，而常以开颅血肿清除为主要治疗手段；由于开颅对患者损伤较大，如全