Clinical efficacy observation and reconsideration of spontaneous hypertension pontine hemorrhage via microsurgery

Q4 Medicine

中华神经医学杂志 Pub Date : 2019-10-15 DOI:10.3760/CMA.J.ISSN.1671-8925.2019.10.005

Shangming Zhang, Ming-chao Shang, Lin Zhao, Liangfeng Wei, Bangqing Yuan

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引用次数: 1

Abstract

Objective To explore the efficacy and experience of surgical approaches of puncture drainage and urokinase thrombolysis for spontaneous hypertensive pontine hemorrhage. Methods The clinical data of 42 patients with spontaneous pontine hemorrhage, admitted to our hospital from January 2014 to December 2018, were retrospectively analyzed. Craniotomy evacuation of hematoma was performed in 18 patients (control group), and puncture drainage and urokinase thrombolysis assisted by neuronavigation was performed in 24 patients (observation group). The clinical efficacies of the two groups were observed and analyzed. Results There were 24 patients having hematoma clearance rate≥50%, including 7 from control group and 17 from observation group. The hematoma clearance rate≥50% in the observation group (70.83%) was significantly higher than that in the control group (38.89%, P 0.05). Conclusion The surgical approach of puncture drainage and urokinase thrombolysis can effectively improve hematoma clearance rate for spontaneous hypertensive pontine hemorrhage, but clinical prognoses are not improved due to influence of multiple factors. Key words: Spontaneous pontine hemorrhage; Puncture drainage and urokinase thrombolysis; Craniotomy evacuation of hematoma

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显微外科治疗自发性高血压脑桥出血的临床疗效观察与思考

目的探讨穿刺引流联合尿激酶溶栓治疗自发性高血压脑桥出血的疗效和经验。方法回顾性分析我院2014年1月至2018年12月收治的42例自发性脑桥出血患者的临床资料。18例患者行开颅血肿引流术(对照组)，24例患者行穿刺引流及神经导航辅助尿激酶溶栓术(观察组)。观察分析两组患者的临床疗效。结果血肿清除率≥50%的患者24例，其中对照组7例，观察组17例。观察组血肿清除率≥50%(70.83%)显著高于对照组(38.89%，P < 0.05)。结论穿刺引流+尿激酶溶栓的手术方式可有效提高自发性高血压脑桥出血的血肿清除率，但由于多种因素的影响，其临床预后并未得到改善。关键词:自发性脑桥出血;穿刺引流和尿激酶溶栓;开颅清除血肿

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