摘要
目的:观察钻颅置管外引流联合尿激酶溶解术治疗老年高血压性脑出血的临床疗效。方法:选取潮州市中心医院2018年1月—2021年7月40例老年高血压性脑出血患者,采用随机数字表法将患者分为手术组与保守组各20例。保守组予以常规保守治疗,手术组患者在保守组治疗基础上采用钻颅置管外引流联合尿激酶溶解术进行治疗。记录并比较手术组与保守组患者神经功能缺损情况、预后状况、日常生活活动能力、脑内血肿清除/吸收时间、意识清醒时间、并发症发生情况、住院时间及临床疗效之间的差异。结果:手术组患者血肿清除/吸收时间、意识清醒时间及住院时间短于保守组,差异有统计学意义(P<0.05);日常生活能力评分(ADL)、Ba r t h e l指数(BI)、格拉斯哥预后评分(GOS)高于保守组,差异有统计学意义(P<0.05);美国国立卫生研究院卒中量表(NIHSS)评分低于保守组,差异有统计学意义(P<0.05)。手术组治疗有效率(90.00%)高于保守组(60.00%),差异有统计学意义(P<0.05)。手术组并发症发生率(5%)低于保守组(30.00%),差异有统计学意义(P<0.05)。结论:对老年高血压性脑出血患者进行钻颅置管外引流联合尿激酶溶解术治疗疗效显著,有利于患者日常生活活动能力和神经功能缺损情况的改善,安全性较高,值得临床应用。
Objective To explore and analyze the clinical effect of extracranial drainage combined with urokinase lysis in the treatment of senile hypertensive intracerebral hemorrhage.Methods 40 elderly patients with hypertensive intracerebral hemorrhage in Chaozhou Central Hospital from January 2018 to July 2021 were selected as the research object.The patients were randomly divided into operation group and conservative group,with 20 cases in each group.The patients in the conservative group were treated with routine conservative treatment,and the patients in the operation group were treated with craniotomy and external drainage combined with urokinase lysis.The differences of neurological deficit,prognosis,activities of daily living,clearance/absorption time of intracerebral hematoma,conscious time,complications,hospital stay and clinical efficacy between the operation group and the conservative group were recorded and compared.Results The hematoma clearance/absorption time,conscious time and hospital stay in the operation group were significantly shorter than those in the conservative group(P<0.05);The scores of activities of daily living(ADL),Barthel Index(BI)and Glasgow prognosis score(GOS)were significantly higher than those in the conservative group(P<0.05),and the National Institutes of Health Stroke Scale(NIHSS)was significantly lower than that in the conservative group(P<0.05).The effective rate of operation group(90.00%)was significantly higher than that of conservative group(60.00%)(P<0.05).The incidence of complications in the operation group(5%)was significantly lower than that in the conservative group(30.00%)(P<0.05).Conclusion For elderly patients with hypertensive intracerebral hemorrhage,skull drilling and external drainage combined with urokinase lysis is effective,which is conducive to the improvement of patients’activities of daily living and neurological impairment.It has high safety and is worthy of popularization.
作者
章炜杰
谢树波
蔡玮
ZHANG Weijie;XIE Shubo;CAI Wei(Department of Neurosurgery,Chaozhou Central Hospital,Chaozhou,Guangdong 521000,China)
出处
《医药前沿》
2022年第11期18-21,共4页
Journal of Frontiers of Medicine
基金
潮州市卫生健康局科研项目(潮卫科研2020072)。
关键词
老年
高血压性脑出血
钻颅置管外引流
尿激酶
临床效果
Old age
Hypertensive intracerebral hemorrhage
Extracranial drainage by drilling skull
Urokinase
Clinical effect
