Comparison between Skull Drill Drainage-urokinase Perfusion and Small Bone Flap Craniotomy for Removing the Hematoma in Hypertensive Cerebral Hemorrhage_West China Medical Journal

Authors：

ZHU Chengming ¹ , YAO Wenhua ¹ , WANG Guifu ² , ZHANG Deming ¹

1. Department of neurosurgery, People′s Hospital of Ya′an, Ya′an, Sichuan 625000, P. R. China; 2. Zunyi Medical College, Zunyi, Guizhou 563000,P.R.China;

Corresponding?author：

Keywords：

血壓腦出血; 腦外科手術; 開顱血腫清除術; 鉆孔引流術; 療效分析

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【摘要】　目的　比較鉆孔引流尿激酶溶解術和小骨窗開顱術治療高血壓腦出血的療效。　方法　 2008年9月-2009年12月分別接受鉆孔引流尿激酶溶解術（A組，n=34）和小骨窗開顱術（B組，n=30）的高血壓腦出血患者共64例（出血量30~50 mL，無腦疝），兩組患者術前基線指標（如出血量、手術時機、昏迷程度等）比較無統計學意義。比較接受不同術式的兩組患者手術時間、術后1個月的近期療效、術后6個月遠期療效及死亡率。　結果　 A組手術時間短于B組，兩組比較，有統計學意義（P lt;0.05）。術后1、6個月，A組療效優于B組，兩組比較，有統計學意義（P lt;0.05）。A、B組術后近期和遠期死亡率比較，無統計學意義（P gt;0.05）。　結論　對出血部位在基底節區、出血量在30~50 mL，無腦疝的高血壓腦出血患者，鉆孔引流尿激酶溶解術的療效明顯優于小骨窗開顱術。
【Abstract】　Objective　 To compare the therapeutic effect of drill drainage-urokinase perfusion (group A) and small bone flap craniotomy on hypertensive intracerebral hemorrhage.　Methods　 A total of 64 patients with hypertensive intracerebral hemorrhage (about 30-50 mL) from September 2008 to December 2009 were collected. The patients underwent drill drainage-urokinase perfusion (group A,n=34) and small bone flap craniotomy (group B,n=30). The therapeutic effects, including operating time, short-term effect within one month, long-term effect six months after operation, operation time, and the rate of rehaemorrhagia and mortality were observed and the results of the two groups were compared.　Results　 The operation time was shorter in group A than that in group B (P lt;0.05); one month and six months after the operation, the therapeutic effects were better in group A than those in group B (P lt;0.05); the difference in mortality between the two groups was not significant (P gt;0.05).　Conclusion　 The therapeutic effect of drill draiage-urokinase perfusion is better than that of small bone flap craniotomy on the patients with hypertensive intracerebral hemorrhage in basal unclei with bleeding amount of 30-50 mL and without cerebralhern.

Citation： ZHU Chengming,YAO Wenhua,WANG Guifu,ZHANG Deming. Comparison between Skull Drill Drainage-urokinase Perfusion and Small Bone Flap Craniotomy for Removing the Hematoma in Hypertensive Cerebral Hemorrhage. West China Medical Journal, 2010, 25(11): 2035-2038. doi: Copy

1.	Tzaan WC, Lee ST, Lui TN. Combined used stereotacfic aspiration and intracerebral streptokinase infusion in the surgical treatment of hypertensive intracerebral hemorrhage[J]. Formos Med Assoc, 1997, 56(96): 962-967.
2.	陳祎陽, 焦德讓. 高血壓腦出血的外科治療進展[J]. 中國老年病學雜志, 2006, 4(26): 566-567.
3.	Vanghan PJ, Pike CJ, Cotman CW, et al. thrombin Receptor activation protect neuron and astrocytes from cell death produced environmental insults [J]. Neuron Sci, 1995, 15(7) 5389-5401.
4.	腦卒中患者臨床神經功能缺損程度評分標準(1995 年全國第四屆腦血管病學術會議通過)[J]. 中華神經科雜志, 1996, 29 (6): 381-383.
5.	Jennett B, Bond M. Assessment of outcome after severe brain damage, a practical scale[J]. Lancet, 2005, 1(11): 480-483.
6.	王忠誠. 神經外科學[M]. 武漢: 湖北科學技術出版社, 2004: 867-874.
7.	Kobagashis, Sato A, Kageyamay, et al. Treatment of hypertensive Cerebral hemorrhage surgical or conservative management [J]. Neurosurgery, 1994, 34 (2): 246.
8.	Kingman TA, Mendelow AD, Graham DE, et al. Experimental intracerebral hemorrhage mass description of model intracranial pressure change and neuropathology [J]. Neuro pathol Exp Neurol, 1998, 47(2): 118-137.
9.	Rohde V, Rohde I, Reinges MHT, et al. Frameless stereotactically guided catheter placement and fibrinolytic therapy for sportaneous intracerebral hematomas: technique aspects and initial clinical results [J]. Minim Invasive Neurosurg, 2000, 43(1): 9-17.
10.	Xi G, Wagner KR, Keep RF, et al. Role of blood clod formation on early edema development after experimental intracerebral hemorrhage [J]. Stroke, 1992, 29 (12): 2580-2586.
11.	楊蜀蓮, 李舜偉, 王國相, 等. 高血壓動脈硬化性腦出血1003例分析[J]. 中華內科雜志, 1995, 20(3): 138.
12.	朱洪春, 唐仕芳. 高血壓性腦出血3種治療方法的療效觀察[J]. 重慶醫學, 2004, 33(6): 825-826.
13.	Prasad K, Rrowan G, sirvastava A, et al. Surgery in primary supratentorial intracerebral hematoma: A meta-analysis of randomized trails[J]. Acta Neurol Scand, 1997, 95(6): 103-110.
14.	Batjier HH, Teisch JS, Allen BC, et al. Failure of surgery to improve outcome of hgpertensive hemorrhage[J]. Arch Newrol Scard, 1990, 47: 1100-1103.

1. 　Tzaan WC, Lee ST, Lui TN. Combined used stereotacfic aspiration and intracerebral streptokinase infusion in the surgical treatment of hypertensive intracerebral hemorrhage[J]. Formos Med Assoc, 1997, 56(96): 962-967.
2. 　陳祎陽, 焦德讓. 高血壓腦出血的外科治療進展[J]. 中國老年病學雜志, 2006, 4(26): 566-567.
3. 　Vanghan PJ, Pike CJ, Cotman CW, et al. thrombin Receptor activation protect neuron and astrocytes from cell death produced environmental insults [J]. Neuron Sci, 1995, 15(7) 5389-5401.
4. 　腦卒中患者臨床神經功能缺損程度評分標準(1995 年全國第四屆腦血管病學術會議通過)[J]. 中華神經科雜志, 1996, 29 (6): 381-383.
5. 　Jennett B, Bond M. Assessment of outcome after severe brain damage, a practical scale[J]. Lancet, 2005, 1(11): 480-483.
6. 　王忠誠. 神經外科學[M]. 武漢: 湖北科學技術出版社, 2004: 867-874.
7. 　Kobagashis, Sato A, Kageyamay, et al. Treatment of hypertensive Cerebral hemorrhage surgical or conservative management [J]. Neurosurgery, 1994, 34 (2): 246.
8. 　Kingman TA, Mendelow AD, Graham DE, et al. Experimental intracerebral hemorrhage mass description of model intracranial pressure change and neuropathology [J]. Neuro pathol Exp Neurol, 1998, 47(2): 118-137.
9. 　Rohde V, Rohde I, Reinges MHT, et al. Frameless stereotactically guided catheter placement and fibrinolytic therapy for sportaneous intracerebral hematomas: technique aspects and initial clinical results [J]. Minim Invasive Neurosurg, 2000, 43(1): 9-17.
10. 　Xi G, Wagner KR, Keep RF, et al. Role of blood clod formation on early edema development after experimental intracerebral hemorrhage [J]. Stroke, 1992, 29 (12): 2580-2586.
11. 　楊蜀蓮, 李舜偉, 王國相, 等. 高血壓動脈硬化性腦出血1003例分析[J]. 中華內科雜志, 1995, 20(3): 138.
12. 　朱洪春, 唐仕芳. 高血壓性腦出血3種治療方法的療效觀察[J]. 重慶醫學, 2004, 33(6): 825-826.
13. 　Prasad K, Rrowan G, sirvastava A, et al. Surgery in primary supratentorial intracerebral hematoma: A meta-analysis of randomized trails[J]. Acta Neurol Scand, 1997, 95(6): 103-110.
14. 　Batjier HH, Teisch JS, Allen BC, et al. Failure of surgery to improve outcome of hgpertensive hemorrhage[J]. Arch Newrol Scard, 1990, 47: 1100-1103.

West China Medical Journal

Comparison between Skull Drill Drainage-urokinase Perfusion and Small Bone Flap Craniotomy for Removing the Hematoma in Hypertensive Cerebral Hemorrhage

Abstract Full text Figures/Tables Video References Cited by

Format

Content