Department of Neurosurgery, Zhuji People' Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang, China.
Department of Neurosurgery, Zhuji People' Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang, China.
Prog Brain Res. 2021;266:349-355. doi: 10.1016/bs.pbr.2021.06.017. Epub 2021 Oct 6.
This study discusses the therapeutic effect of high-dose urokinase treatment for hypertension ventricular hemorrhage.
A total of 60 patients with hypertension ventricular hemorrhage were randomly assigned to two groups: treatment group (n=30) and control group (n=30). Both groups received bilateral external ventricular drain. The treatment group was injected with 50,000IU urokinase to the lateral ventricle every day; the total injection volume per day was 100,000IU. The control group was injected with 20,000IU urokinase to the lateral ventricle every day with a total injection volume per day of 40,000IU. Lumbar puncture was performed in both groups after the later ventricular drain was removed to release cerebrospinal fluid (CSF). Head Computed tomography(CT) examination was performed regularly to observe changes in the ventricular hematoma as well as the occurrence of complications such as intracranial infection and hydrocephalus. Patient prognosis 6 weeks after surgery was compared between the two groups.
In the treatment group, the intraventricular hemorrhage clearance time and the number of instances of urokinase treatment were significantly less than those of the control group (P<0.05). The total urokinase dosage of the treatment group was significantly higher than that of the control group (P<0.05). With respect to post-surgery complications, in the treatment group, there were three cases of hydrocephalus and one case of intracranial infection. In the control group, there were four cases of hydrocephalus and three cases of intracranial infection. Intraventricular re-hemorrhage was not observed in either group. Intracranial infection was relieved after strengthened anti-infective therapy and continuous drainage. There was a statistically significant difference in the occurrence of complications between the treatment group and the control group (P<0.05). The rate of good prognosis in the treatment group was higher than that of the control group (P<0.05), and the inefficiency rate was lower (P<0.05).
High-dose urokinase treatment produces a significant therapeutic effect in hypertension ventricular hemorrhage. This treatment can quickly eliminate intraventricular hemorrhage, shorten the ventricular drain tube indwelling time, decrease the occurrence of intracranial infection, and increase the likelihood of a good prognosis.
本研究探讨了大剂量尿激酶治疗高血压性脑室出血的疗效。
将 60 例高血压性脑室出血患者随机分为两组：治疗组（n=30）和对照组（n=30）。两组均行双侧脑室外引流。治疗组每天向侧脑室注入 5 万 U 尿激酶，每天总注射量为 10 万 U；对照组每天向侧脑室注入 2 万 U 尿激酶，每天总注射量为 4 万 U。两组均在拔除侧脑室引流管后行腰椎穿刺释放脑脊液（CSF）。定期行头颅 CT 检查，观察脑室血肿变化及颅内感染、脑积水等并发症发生情况。比较两组患者术后 6 周的预后。
治疗组患者脑室血肿清除时间及尿激酶治疗次数明显少于对照组（P<0.05），治疗组总尿激酶用量明显高于对照组（P<0.05）。术后并发症方面，治疗组有 3 例脑积水，1 例颅内感染；对照组有 4 例脑积水，3 例颅内感染。两组均未出现再出血。颅内感染经加强抗感染治疗和持续引流后均得到缓解。治疗组并发症发生率明显低于对照组（P<0.05）。治疗组预后良好率高于对照组（P<0.05），无效率低于对照组（P<0.05）。
大剂量尿激酶治疗高血压性脑室出血疗效显著，能快速消除脑室积血，缩短脑室引流管留置时间，降低颅内感染发生率，提高预后良好率。
