Abstract:

Objective　To analyze the effects of intracranial hematoma puncture urokinase liquefaction versus decompressive hematoma removal through bone flap in the treatment of patients with hypertensive intracerebral hemorrhage. Methods　Eighty-four patients with hypertensive intracerebral hemorrhage admitted to Bayannur Hospital from August 2018 to August 2022 were selected as the research objects. There were 41 cases in the observation group, including 23 males and 18 females; they were 41-73 (63.2±9.5) years old. There were 43 cases in the control group, including 21 males and 22 females; they were 43-76 (59.3±11.8) years old. The observation group were treated with intracranial hematoma puncture urokinase liquefaction, and the control group with decompressive hematoma removal through bone flap. The surgical status, hospitalization costs, and scores of Glasgow Outcome Scale (GOS) in the 2 groups were compared. χ² and t tests were applied. Results　The operation time, treatment cost, hospital stay in the observation group were lower than those in the control group [(0.82±0.24) h vs. (3.61±0.56) h, (46 380.51±35 633.35) yuan vs. (72 834.60±32 785.26) yuan, (15.52±13.50) d vs. (23.32±16.83) d], with statistical differences (t=29.42, 3.48, and 2.34; all P<0.05). After the treatment, the scores of National Institute of Health Stroke Scale (NIHSS) and Barthel Index (BI) in the observation group were better than those in the control group [(12.87±3.13) vs. (18.98±4.85) and (82.23±7.94) vs. (56.88±6.79)], with statistical differences (t=6.82 and 15.75; both P<0.05). Conclusion　Intracranial hematoma puncture urokinase liquefaction has the advantages of shorter operation time, lower treatment cost, and shorter hospitalization time than decompressive hematoma removal through bone flap, and is safe and effective and can reduce neurological damage and improve the patients rehabilitation and life quality.

Key words:

Hypertensive cerebral hemorrhage, Puncture of intracranial hematoma, Urokinase liquefaction, Decompression through bone flap

摘要：

目的　对比分析颅内血肿穿刺尿激酶液化与去骨瓣减压血肿清除治疗高血压脑出血患者的疗效。方法　选取2018年8月至2022年8月在巴彦淖尔市医院收治的84例高血压脑出血患者作为研究对象，按治疗方法分为观察组与对照组。观察组41例，其中男性23例，女性18例，年龄41～73（63.2±9.5）岁，接受颅内血肿穿刺尿激酶液化术治疗；对照组43例，其中男性21例，女性22例，年龄43～76（59.3±11.8）岁，接受去骨瓣减压血肿清除术治疗。比较两组患者手术情况、住院花费、格拉斯哥预后（GOS）评分。统计学方法采用χ²检验、t检验。结果　观察组手术时间、治疗费用、住院天数明显低于对照组［（0.82±0.24）h比（3.61±0.56）h、（46 380.51±35 633.35）元比（72 834.60±32 785.26）元、（15.52±13.50）d比（23.32±16.83）d］，差异均有统计学意义（t=29.42、3.48、2.34，均P<0.05）。治疗后，观察组的美国国立卫生研究院卒中量表（NIHSS）评分低于对照组［（12.87±3.13）分比（18.98±4.85）分］，观察组Barthel 指数评分高于对照组［（82.23±7.94）分比（56.88±6.79）分］，差异均有统计学意义（t=6.82、15.75，均P<0.05）。结论　颅内血肿穿刺尿激酶液化术治疗高血压脑出血与去骨瓣减压血肿清除术相比，颅内血肿穿刺尿激酶液化术更为安全、有效，能明显缩短手术时间、减轻神经组织损伤，有利于术后康复，缩短术后住院时间，减少住院费用，从而改善患者生活质量。

关键词:

高血压脑出血, 颅内血肿穿刺, 尿激酶, 去骨瓣减压术