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目的观察微创穿刺联合尿激酶冲洗在高血压脑出血(HICH)患者中的应用效果,探讨其对局部脑血流的影响。方法选取2012年10月—2016年8月禹城市中医院外二科收治的HICH患者104例,根据治疗方案分为对照组和观察组,每组52例。在常规治疗基础上,对照组患者给予单纯微创穿刺引流术,观察组患者给予微创穿刺引流术联合尿激酶冲洗。比较两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分,额顶叶区、中心区、周边远区、周边近区脑血流量及术后3个月预后。结果治疗前两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗后观察组患者NIHSS评分低于对照组(P<0.05)。治疗前两组患者额顶叶区、中心区、周边远区、周边近区脑血流量比较,差异无统计学意义(P>0.05);治疗后观察组患者周边远区、周边近区脑血流量大于对照组(P<0.05),而两组患者额顶叶区、中心区脑血流量比较,差异无统计学意义(P>0.05)。术后3个月观察组患者预后良好率高于对照组(P<0.05)。结论微创穿刺引流联合尿激酶在HICH患者中的应用效果良好,可有效改善患者局部脑血流、神经功能及预后。
Objective To observe the effect of minimally invasive puncture combined with urokinase in patients with hypertensive intracerebral hemorrhage (HICH) and to explore its effect on regional cerebral blood flow. Methods A total of 104 HICH patients admitted to the Second Hospital of Yucheng Chinese Medicine Hospital from October 2012 to August 2016 were selected and divided into control group and observation group with 52 cases in each group. On the basis of routine treatment, patients in the control group were treated with minimally invasive puncture and drainage, while patients in the observation group were given minimally invasive puncture and drainage combined with urokinase. The National Institutes of Health Stroke Scale (NIHSS) score, frontal parietal area, central area, peripheral area, peripheral blood flow in peripheral area and prognosis at 3 months after operation were compared between the two groups before and after treatment. Results There was no significant difference in NIHSS score between the two groups before treatment (P> 0.05). NIHSS score in observation group was lower than that in control group after treatment (P <0.05). There was no significant difference in the amount of cerebral blood flow in frontal area, central area, peripheral area and surrounding area between the two groups before treatment (P> 0.05). After treatment, the distance between the peripheral area and peripheral area (P <0.05). However, there was no significant difference in the amount of cerebral blood flow between the frontal lobe and the center of the two groups (P> 0.05). The good prognosis of observation group was higher than that of control group 3 months after operation (P <0.05). Conclusion Minimally invasive puncture drainage combined with urokinase has a good effect in HICH patients, which can effectively improve the local cerebral blood flow, neurological function and prognosis.