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目的探讨硬通道联合尿激酶冲洗引流治疗慢性硬膜下血肿的临床疗效。方法 48例慢性硬膜下血肿患者,根据Bender分级:0级3例、Ⅰ级10例、Ⅱ级27例、Ⅲ级8例、Ⅳ级0例。应用YL-1型一次性颅内血肿粉碎针穿刺冲洗引流血肿,术后小量生理盐水等量反复冲洗,24h后复查头颅CT,对残留血肿辅以尿激酶纤溶治疗,2～3次/d,直至血肿基本清除,并分析硬通道联合尿激酶冲洗引流术的安全性和实用性。结果 48例均一次性成功,经过3～7d冲洗引流,血肿清除。出院时重新对患者进行Bender分级评分:0级37例、Ⅰ级8例、Ⅱ级3例、Ⅲ级0例、Ⅳ级0例。均无颅内出血、颅内感染、急性脑膨胀、张力性气颅及癫痫等并发症发生,48例患者出院1月后复查头颅CT无复发。结论硬通道联合尿激酶治疗硬膜下血肿手术安全可靠、创伤小、方法简便易行,清除血肿迅速,值得临床推广使用。
Objective To investigate the curative effect of hard channel combined with urokinase flushing and drainage on chronic subdural hematoma. Methods 48 cases of chronic subdural hematoma patients, according to Bender classification: 0 in 3 cases, Ⅰ in 10 cases, Ⅱ in 27 cases, Ⅲ in 8 cases, Ⅳ in 0 cases. The application of YL-1 disposable intracranial hematoma crush needle puncture and flush drainage hematoma, a small amount of normal saline after repeated flushing, 24 hours after head CT review of residual hematoma with urokinase fibrinolysis, 2 to 3 times / d until the hematoma basically cleared, and analyze the safety and practicality of hard channel combined with urokinase flushing and drainage. Results All the 48 cases were successful in one time. After 3 to 7 days, the hematoma was cleared. Patients were re-Bender scoring grading: 0 in 37 cases, Ⅰ grade in 8 cases, Ⅱ in 3 cases, Ⅲ in 0 cases, Ⅳ in 0 cases. No intracranial hemorrhage, intracranial infection, acute brain swelling, tension and other complications of epilepsy and cranial airway occurred, 48 patients were discharged from the hospital after a review of the head CT no recurrence. Conclusion The combination of hard channel and urokinase in the treatment of subdural hematoma is safe and reliable, the trauma is small, the method is simple and easy to operate, and the hematoma is cleared rapidly. It is worth to be used clinically.