摘要
目的观察不同剂量尿激酶用于脑室出血铸型的溶血效果。方法选择脑室出血患者200例,将患者随机分为治疗组1、治疗组2、治疗组3、治疗组4、治疗组5。五组均行双侧脑室微创穿刺引流术,治疗组1予尿激酶灌注2万单位;灌注后夹闭1 h开放引流管,次日复查头颅CT。治疗组2予尿激酶灌注4万单位;灌注后夹闭1 h开放引流管,次日复查头颅CT。治疗组3予尿激酶灌注6万单位;灌注后夹闭1 h开放引流管,次日复查头颅CT。治疗组4予尿激酶灌注8万单位;灌注后夹闭1 h开放引流管,次日复查头颅CT。治疗组5予尿激酶灌注10万单位;灌注后夹闭1 h开放引流管,次日复查头颅CT。观察对比五组患者脑室血肿排出量。结果治疗组1血肿排出量为(8.28±1.06)mL,治疗组2血肿排出量为(10.70±2.08)mL,治疗组3血肿排出量为(14.28±2.34)mL,治疗组4血肿排出量为(15.83±2.78)mL,治疗组5血肿排出量为(19.93±2.97)mL;并发症(颅内感染发生率):治疗组1为17.95%,治疗组2为5.00%,治疗组3为2.63%,治疗组4为5.00%,治疗组5为2.56%。治疗组1颅内感染发生率最高,差异有统计学意义;并发症(再出血发生率):治疗组1为0,治疗组2为0,治疗组3为2.63%,治疗组4为10.00%,治疗组5为15.38%。提示随着尿激酶剂量的增大,再出血发生率增高,差异有统计学意义。结论4~6万单位剂量尿激酶在脑室出血患者中使用最合适,并发症最少。
Objective To observe the hemolytic effect of different doses of urokinase on ventricular hemorrhage casting.Methods 200 patients with ventricular hemorrhage were selected and randomly divided into treatment group 1,treatment group 2,treatment group 3,treatment group 4,and treatment group 5.All patients were underwent bilateral ventricular minimally invasive puncture and drainage,and perfused with 20000U,40000U,60000U,80000U,100000U urokinase in the treatment group 1,treatment group 2,treatment group 3,treatment group 4,treatment group 5,respectively.After perfusion,the drainage tube was clamped for 1 hour and open it,and cranial CT scan was performed the next day.The output of ventricular hematoma in five groups were observed and compared.Results The hematoma output in treatment group 1 was 8.28±1.06 mL,in treatment group 2 was 10.70±2.08 mL,in treatment group 3 was 14.28±2.34 mL,in treatment group 4 was 15.83±2.78 mL,and in treatment group 5 was 19.93±2.97 mL.The incidence of intracranial infection in treatment Group 1 was 17.95%,in treatment Group 2 was 5.00%,in treatment Group 3 was 2.63%,in treatment Group 4 was 5.00%,and in treatment Group 5 was 2.56%.The incidence of intracranial infection was highest in treatment group 1,and the difference was statistically significant.The recurrence rate of treatment group 1 was 0,treatment group 2 was 0,treatment group 3 was 2.63%,treatment group 4 was 10.00%,and treatment group 5 was 15.38%.As the dosage of urokinase increases,the incidence of rebleeding increased,and the difference was statistically significant.Conclusion The use of 40000U to 60000U urokinase is most suitable for patients with ventricular hemorrhage,with minimal complications,and is suitable for clinical promotion.
作者
王黎云
李谷
WANG Liyun;GU Li(Shengzhou People's Hospital(The First Affiliated Hospital of Zhejiang University Shengzhou Branch),Zhejaing 312400,China)
出处
《浙江创伤外科》
2024年第6期1024-1026,1033,共4页
Zhejiang Journal of Traumatic Surgery
基金
2021年浙江省卫生健康面上项目(2021KY380)。
关键词
不同剂量尿激酶
脑室出血
脑室外引流术
Different doses of urokinase
Ventricular hemorrhage
Puncture and drainage
