王晶 黃莉

【摘 要】 ?目的 ： 對(duì)比腦出血微創(chuàng)鉆孔引流與尿激酶對(duì)顱內(nèi)血塊溶解的效果。方法 ： 2018年4月至2019年4月選擇在本院診治的腦出血患者84例，隨機(jī)分為兩組。研究組給予微創(chuàng)鉆孔引流治療，對(duì)照組給予尿激酶治療，記錄顱內(nèi)血塊溶解效果。結(jié)果 ： 治療后觀察組的總有效率顯著高于對(duì)照組（P<0.05）;治療后觀察組的血腫清除率顯著高于對(duì)照組（P<0.05）;治療后兩組的血清GFAP含量都顯著低于治療前，觀察組也顯著低于對(duì)照組（P<0.05）;觀察組閉管時(shí)間及引流時(shí)間都顯著少于對(duì)照組（P<0.05）。結(jié)論 ： 相對(duì)于尿激酶，微創(chuàng)鉆孔引流在腦出血中的應(yīng)用能促進(jìn)顱內(nèi)血塊溶解，抑制血清GFAP的釋放，減少閉管時(shí)間及引流時(shí)間，從而提高治療效果。

【關(guān)鍵詞】 ?微創(chuàng)鉆孔引流;尿激酶;腦出血;顱內(nèi)血塊

Comparison of the effect of minimally invasive drilling drainage and urokinase on intracranial blood clot lysis in patients with cerebral hemorrhage

Wang Jing， Huang Li

Fourth People's Hospital of Tianshui， Tianshui， Gansu 741020

[Abstract] ?Objective：To compare the effects of minimally invasive drilling drainage and urokinase on intracranial blood clot lysis in patients with cerebral hemorrhage. Methods： From April 2018 to April 2019， 84 patients with cerebral hemorrhage were selected and divided into two groups. The study group was treated with minimally invasive drilling drainage， while the control group was treated with urokinase. The effect of intracranial blood clot dissolution was recorded. Results： After treatment， the total effective rate of the study group was significantly higher than that of the control group （P<0.05）. After treatment， the hematoma clearance rate in the study group was significantly higher than that in the control group （P<0.05）. After treatment， the serum GFAP content in both groups was significantly lower than that before treatment， and the study group was also significantly lower than that in the control group （P<0.05）. The closure time and drainage time of the study group were significantly less than those of the control group （P<0.05）. Conclusion： Compared with urokinase， the application of minimally invasive drilling drainage in cerebral hemorrhage can promote the dissolution of intracranial blood clots， inhibit the release of serum GFAP， reduce the time of closure and drainage， and thus improve the therapeutic effect.

[Key words] Minimally invasive drilling drainage; Urokinase; Cerebral hemorrhage; Intracranial blood clot

腦出血是嚴(yán)重危害人類健康的常見(jiàn)病，具有高發(fā)病率、高致殘率、高病死率等“三高”特征。流行病學(xué)顯示我國(guó)腦出血患者占所有腦血管疾病患者的30.0%左右，1個(gè)月內(nèi)的病死率接近20.0%[1]。特別是腦出血后引起機(jī)體和腦組織局部一系列病理性反應(yīng)，包括腦內(nèi)血腫的擴(kuò)大，從而釋放出大量的血管活性物質(zhì)，誘發(fā)機(jī)體出現(xiàn)腦水腫，并可導(dǎo)致局部腦血流量減少[2]。隨著醫(yī)學(xué)技術(shù)的發(fā)展，微創(chuàng)技術(shù)在腦出血患者中的應(yīng)用越來(lái)越多。其中腦出血微創(chuàng)鉆孔引流具有操作簡(jiǎn)單、創(chuàng)傷小、并發(fā)癥少、易于掌握、效果確切等優(yōu)點(diǎn)，能減少因血腫占位、血腫毒性引發(fā)的腦組織損害，促進(jìn)患者恢復(fù)[3]。而尿激酶經(jīng)引流管注入可加速腦內(nèi)血腫自引流管排出，也可促進(jìn)血腫溶解液化，減少并發(fā)癥的發(fā)生，有助于提高臨床療效，降低致死率、致殘率。神經(jīng)膠質(zhì)纖維酸性蛋白（Glial fibrillary acidic protein，GFAP）是一種中間絲蛋白，被認(rèn)為是 星形膠質(zhì)細(xì)胞的特異性標(biāo)志物，是星形膠質(zhì)細(xì)胞的細(xì)胞骨架[4]。本文對(duì)比了腦出血微創(chuàng)鉆孔引流與尿激酶對(duì)顱內(nèi)血塊溶解的效果，以明確其應(yīng)用價(jià)值與機(jī)制?，F(xiàn)總結(jié)報(bào)道如下。

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