临床神经外科杂志2025，Vol.22Issue(3)：314-319,6.DOI:10.3969/j.issn.1672-7770.2025.03.013
尿激酶联合CT引导穿刺引流术治疗基底节区高血压脑出血患者的疗效及安全性分析
Analysis of efficacy and safety of CT-guided puncture and drainage with adjunctive urokinase in the treatment of hypertensive cerebral hemorrhage in basal ganglia
摘要
Abstract
Objective To explore the therapeutic efficiency and safety profile of a combination therapy involving urokinase and CT-directed puncture drainage for managing basal ganglia hypertensive cerebral hemorrhage.Methods A total of 96 individuals suffering from hypertensive cerebral hemorrhage in the basal ganglia,who were treated at CT Room of Zhangjiakou First Hospital from January 2022 to December 2023 were enrolled.These patients were randomly divided into control group and experimental group,with an equal number of 48 participants in each.Traditional craniotomy was the treatment approach for the control group,whereas the experimental group received CT-guided puncture and drainage with adjunctive urokinase.The outcomes of the two groups were compared,including therapeutic outcomes,postoperative recuperation measured by hematoma resolution rate,time to spontaneous opening,cerebral edema volume one week post-surgery,and Glasgow coma scale(GCS),stress-related tumor indices,including adrenocorticotropic hormone(ACTH)and serum cortisol(Cortisol,ACTH,Cor),and the rate of complications,such as rebleeding,gastrointestinal bleeding,intracranial infection,pulmonary infection,seizures,and brain herniation.Results The experimental group demonstrated a superior total efficacy rate compared to the control group(P＜0.05).Additionally,this group exhibited reduced self-opening times and postoperative cerebral edema volumes at one week,along with increased hematoma resolution rates and GCS scores one week post-surgery,when contrasted with the control group(P＜0.05).Post-treatment,both groups showed elevated levels of stress-related tumor indices,but the experimental group had lower levels compared to the control group(P＜0.05).Moreover,the experimental group experienced a lower incidence of adverse events than the control group(P＜0.05).Conclusions The therapeutic approach combining urokinase with CT-guided puncture and drainage for treating basal ganglia hypertensive cerebral hemorrhage patients is proved to be clinically effective.It enhances postoperative recovery,mitigates postoperative stress responses,improves patient prognosis,and exhibits a high level of safety,thus warranting wider adoption and consideration.关键词
尿激酶/CT引导/穿刺引流术/基底节区高血压脑出血/疗效/安全性Key words
urokinase/CT guidance/puncture drainage/hypertensive cerebral hemorrhage in basal ganglia/curative effect/safety分类
医药卫生引用本文复制引用
史彪,丁奇,马晓璇,阮维圣,陆海永,刘伟亮..尿激酶联合CT引导穿刺引流术治疗基底节区高血压脑出血患者的疗效及安全性分析[J].临床神经外科杂志,2025,22(3):314-319,6.基金项目
2020年度河北省医学科学研究课题计划项目(20201602) （20201602）
