脑脊液引出对穿刺治疗基底节区高血压脑出血疗效的影响

doi:10.19854/j.cnki.1008-2425.2024.01.0009

摘要/Abstract

摘要： 目的探讨在接受血肿穿刺引流术联合尿激酶治疗基底节区高血压脑出血的患者中,脑脊液经引流管引出对血肿清除的效果及短期预后的影响。方法回顾性分析75例接受血肿穿刺引流术联合尿激酶治疗的基底节区高血压脑出血病人的临床资料,以治疗过程中是否伴有脑脊液引出作为分组依据,比较伴有脑脊液引出组(A组)和不伴有脑脊液引出组(B组)的血肿清除效果、并发症及短期预后差异。结果与A组相比,B组拔管前血肿残留体积更少(P<0.001),引流管留置时间以及在院时间更短(P=0.002,P=0.003),而两组术后颅内压(intracranial pressure,ICP)和短期预后均无显著差异(P＞0.05)。A组颅内感染率明显升高(P=0.027),A组在院期间甘露醇使用量更少(P=0.038)。结论采用血肿穿刺引流术联合尿激酶治疗基底节区高血压脑出血,不伴有脑脊液引出时血肿清除效果更好,并可以减少颅内感染风险和平均住院日。血肿穿刺引流术联合尿激酶是治疗基底节区高血压脑出血的有效方法。

关键词: 高血压脑出血, 基底节区, 血肿穿刺引流术, 尿激酶

Abstract: Objective To explore the influence of cerebrospinal fluid extraction on drainage effect and short-term prognosis in patients with hypertensive intracerebral hemorrhage (HICH) on the basal ganglia undergoing puncture and drainage combined with urokinase. Methods Clinical data of 75 HICH patients receiving puncture and drainage combined with urokinas were analyzed retrospectively.Based on the presence or absence of CSF drainage during treatment,the differences of drainage effect,complications and short-term prognosis were compared between the group with cerebrospinal fluid extraction (A group) and the group without cerebrospinal fluid extraction (B group). Results Compared with group A,the residue hematoma volume was lower (P<0.001) in group B.And the lengths of hospitalisation and drain tube stay were shorter in group B(P=0.002,P=0.003).While no significant differences in the postoperative complications and short-term prognosis were found between the two groups (P＞0.05).The rate of intracranial infection was significantly elevated in group A(P=0.027).Patients in Group A used less mannitol during hospitalization (P=0.038). Conclusion It had a better drainage effect without cerebrospinal fluid extraction for HICH in the basal ganglia patients receiving puncture and drainage combined with urokinas.Meanwhile,the risk of intracranial infection and the average length of hospital stay reduced.Patients with intraventricular hemorrhage puncture and drainage combined with urokinas was an effective treatment for HICH on the basal ganglia.

Key words: Hypertensive intracerebral hemorrhage (HICH), Basal ganglia, Hematoma puncture and drainage, Urokinase

中图分类号:

R743.34

皇甫罗锴, 毛锦龙, 饶维, 邹明明, 曹卫东, 张剑宁. 脑脊液引出对穿刺治疗基底节区高血压脑出血疗效的影响[J]. 立体定向和功能性神经外科杂志, 2024, 37(1): 44-47.

Huangfu Luokai, Mao Jinlong, Rao Wei, Zou Mingming, Cao Weidong, Zhang Jianning. Curative effect of cerebrospinal fluid extraction on puncture and drainage for the treatment of hypertensive intracerebral hemorrhage on the basal ganglia[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2024, 37(1): 44-47.

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