许奕聪　王能强　林运全　郭华强

【摘要】 目的：探討采用微创穿刺引流联合尿激酶灌注治疗慢性硬膜下血肿的临床综合疗效。方法：选取2014年7月-2017年6月本院收治的慢性硬膜下血肿患者119例为研究对象，按照不同临床治疗方式分成常规手术组（52例）和尿激酶手术组（67例）。常规手术组给予微创穿刺引流治疗，尿激酶手术组给予微创穿刺引流联合尿激酶灌注治疗。观察和比较两组临床指标、死亡率和复发情况。结果：尿激酶手术组的手术时间短于常规手术组，差异有统计学意义（t=17.846 8，P=0.000 0）。尿激酶手术组的拔管时间早于常规手术组，差异有统计学意义（t=6.262 2，P=0.000 0）。尿激酶手术组的住院时间短于常规手术组，差异有统计学意义（t=3.596 8，P=0.000 5）。尿激酶手术组死亡率为1.49%，与常规手术组的1.92%比较，差异无统计学意义（字2=0.032 8，P=0.856 2）。尿激酶手术组术后6个月内复发率为1.49%，显著低于常规手术组的11.54%，差异有统计学意义（字2=5.336 9，P=0.020 9）。结论：采用微创穿刺引流联合尿激酶灌注治疗慢性硬膜下血肿的临床综合疗效显著，术后复发率更低，是临床治疗慢性硬膜下血肿的可靠方案之一。

【关键词】 微创穿刺引流； 尿激酶灌注； 慢性硬膜下血肿

Observation the Clinical Efficacy of Minimally Invasive Puncture Drainage Combined with Ventricle Infusion of Urokinase in Treatment of Chronic Subdural Hematoma/XU Yicong，WANG Nengqiang，LIN Yunquan，et al.//Medical Innovation of China，2018，15（17）：-126

【Abstract】 Objective：To explore the clinical efficacy of minimally invasive puncture drainage combined with ventricle infusion of urokinase in the treatment of patients with chronic subdural hematoma.Method：A total of 119 cases with chronic subdural hematoma in our hospital from July 2014 to June 2017 were selected，they were divided into routine surgery groups（52 cases）and urokinase surgery group（67 cases）according to different clinical treatment methods.The routine surgery group was given with minimally invasive puncture drainage treatment.The urokinase surgery group was given with minimally invasive puncture drainage combined with ventricle infusion of urokinase treatment.The clinical indicators，death rates and recurrence were observed and compared between the two groups.Result：The time of operation in the urokinase surgery group was shorter than that in the routine surgery group，the difference was statistically significant（t=17.846 8，P=0.000 0）.The time of extubation in the urokinase surgery group was sooner than that in the routine surgery group，the difference was statistically significant（t=6.262 2，P=0.000 0）.The hospital stays in the urokinase surgery group was shorter than that in the routine surgery group，the difference was statistically significant（t=3.596 8，P=0.000 5）.The mortality of urokinase group was 1.49%，compared with 1.92% in routine operation group，the difference was not statistically significant（字2=0.032 8，P=0.856 2）.After surgery 6 months，the recurrence rate in the urokinase surgery group was 1.49%，which was lower than 11.54% in the routine surgery group ，the difference was statistically significant（字2=5.336 9，

P=0.020 9）.Conclusion：The clinical effect of the combination of minimally invasive puncture drainage and ventricle infusion of urokinase in the treatment of chronic subdural hematoma is significant，the recurrence rate of patients is lower，it is one of the reliable solutions for the treatment of chronic subdural hematoma.

【Key words】 Minimally invasive puncture drainage； Ventricle infusion of urokinase； Chronic subdural hematoma

First-authors address：Shantou Chaonan Minsheng Hospital，Shantou 515144，China

doi：10.3969/j.issn.1674-4985.2018.17.032

慢性硬膜下血肿患者的颅内出血积聚于硬脑膜与蛛网膜之间，通常在患者头部外伤后的三周以上出现相关症状[1]。临床针对慢性硬膜下血肿患者颅内出血的来源和发病机制研究尚未统一意见，患者发病后的临床表现以颅内压增高为主，多数有不同程度的头痛症状[2]。临床研究和报道认为：引流联合尿激酶灌注治疗方式对慢性硬膜下血肿患者能够起到显著疗效[3]。……