实用医学杂志 ›› 2022, Vol. 38 ›› Issue (11): 1314-1318.doi: 10.3969/j.issn.1006⁃5725.2022.11.003

• 专题报道 • 上一篇    下一篇

YL⁃1型针联合尿激酶注射在治疗中等量基底节区脑出血中的应用

费喜峰 王之敏 孙飞 陈寒春 蒋栋毅   

  1. 上海交通大学医学院苏州九龙医院神经外科(江苏苏州 215028)

  • 出版日期:2022-06-10 发布日期:2022-06-10
  • 通讯作者: 蒋栋毅 E⁃mail:drjiangsz@126.com
  • 基金资助:
    江苏省青年医学重点人才项目(编号:QNRC2016217);苏州市姑苏卫生人才项目(编号:GSWS2020122);苏州市医疗卫生
    科技创新项目(编号:SKY2021028);苏州市科技局科技计划项目(编号:SS2019050)

Application of YL⁃1 needle combined with urokinase injection in the treatment of moderate basal ganglia hemorrhage

FEI Xifeng,WANG Zhimin,SUN Fei,CHEN Hanchun,JIANG Dongyi.   

  1. Department of Neurosur⁃ gery,Suzhou Kowloon Hospital,Shanghai Jiaotong University School of Medicine,Suzhou 215028,China 

  • Online:2022-06-10 Published:2022-06-10
  • Contact: JIANG Dongyi E⁃mail:drjiangsz@126.com

摘要:

目的 探讨 YL⁃1 型针钻孔引流术联合尿激酶注射治疗中等量基底节区出血的临床疗效。 方法 回顾性分析 2013 9 月至 2021 2 月我院收治的 48 例意识清楚或嗜睡伴有肢体和或言语功能 障碍的中等量基底节区高血压脑出血患者(GCS 评分 12~15 分),分别采用 YL⁃1 型针钻孔引流术联合 尿激酶注射治疗和保守治疗,即手术组和对照组。观察比较两组治疗效果、血肿消除时间、并发症发生 率、ADL 预后评定等方面的差异。结果 血肿消除时间:治疗组为(7.50 ± 3.6)d,对照组为(21.14 ± 5.7)d 两组比较差异有统计学意义(P < 0.05)。并发症发生率:两组肺部感染发生率比较差异无统计学意义 P > 0.05);手术组的手术相关并发症中,气颅发生率为 15.4%,颅内感染发生率为 3.8%,穿刺道出血发 生率 3.8%。1 个月后 ADL 预后评定:手术组Ⅰ 5 例,Ⅱ 11 例,Ⅲ 8 例,Ⅳ 2 例,Ⅴ 0 例;对照组 1 例,Ⅱ 4 例,Ⅲ 10 例;Ⅳ 7 例,Ⅴ 0 例,两组比较差异有统计学意义(P < 0.05)。结论 疗中等量基底节区高血压脑出血,YL⁃1 型针穿刺引流术具有操作简单、微创、功能恢复时间快、疗效良 好等优点。

关键词: YL?1型针; , 基底节区出血; , 尿激酶注射

Abstract:

Objective To explore the clinical efficacy of YL⁃1 needle trepanation drainage combined with urokinase injection in the treatment of moderate basal ganglia hemorrhage. Methods We retrospectively analyzed 48 patients with moderate basal ganglia hypertensive cerebral hemorrhage(GCS score 12 ⁃ 15)who were conscious or lethargic with limb and/or speech dysfunction in our hospital from September 2013 to February 2021. The patients received either YL⁃1 needle trepanation drainage combined with urokinase injection(study group)or con⁃ servative treatment(control group). Differences in time to hematoma elimination,complication rate,and ADL prognosis were analyzed. Results The time to hematoma elimination was(7.50 ± 3.6)days in the study group and (21.14 ± 5.7)days in the control group,and the difference between the two groups was statistically significant (P < 0.05). There were no statistical differences in the rate of pulmonary infection between the two groups(P > 0.05). Of the procedure⁃related complications,the incidence was 15.4% for pneumocranium and 3.8% for both intracranial infection and puncture tract bleeding. ADL prognosis assessment one month after the procedure,5 patients were in level Ⅰ,11 in level Ⅱ,8 in level Ⅲ,2 in level Ⅳ,and none in level Ⅴ in the study group;whereas 1 patient in level Ⅰ,4 in level Ⅱ,10 in level Ⅲ,7 in level Ⅳ,and none in level Ⅴ. The difference between the two groups in the number of patients in levels Ⅱ and Ⅳ was statistically significant(P < 0.05). Conclusions For the treatment of moderate hypertensive cerebral hemorrhage in the basal ganglia area ,YL ⁃ 1 needle trepanation drainage has the advantages of simple operation,minimal invasiveness,faster functional recovery,and better curative effect.

Key words:

YL?1 needle, basal ganglia hemorrhage, urokinase injection