2024 年第 10 期 第 19 卷

CT引导下血肿穿刺引流术中应用不同剂量尿激酶治疗老年高血压脑出血的效果观察

Observation on the effect of different doses of urokinase on elderly patients with hypertensive cerebral hemorrhage during CT-guided hematoma puncture and drainage

作者：阮维圣马晓璇史彪赵春龙吕超

英文作者：Ruan Weisheng Ma Xiaoxuan Shi Biao Zhao Chunlong Lyu Chao

单位：河北省张家口市第一医院CT室，张家口075000

英文单位：CT Room Zhangjiakou First Hospital Hebei Province Zhangjiakou 075000 China

关键词：老年高血压脑出血；CT引导；血肿穿刺引流术；大剂量尿激酶

英文关键词：Hypertensivecerebralhemorrhageintheelderly;CT-guided;Hematomapunctureanddrainage;High-doseurokinase

• 摘要：

• 目的 研究CT引导下血肿穿刺引流术中应用不同剂量尿激酶治疗老年高血压脑出血的效果。方法 选取2021年6月至2023年10月于河北省张家口市第一医院行CT引导下血肿穿刺引流术治疗的60例老年高血压脑出血患者为研究对象，按照随机数字表法分为对照组和观察组，每组30例。对照组应用小剂量尿激酶治疗，剂量为2万U。观察组应用大剂量尿激酶治疗，剂量为5万U。2组均治疗2周。比较2组治疗效果、并发症发生情况、神经病残疾评分（NDS）、日常生活活动能力评定量表（ADL）、格拉斯哥预后评分（GOS）、炎性因子水平。结果 观察组治疗总有效率高于对照组［96.7%（29/30）比73.3%（22/30）］，差异具有统计学意义（χ2=7.862，P<0.001）。2组并发症发生率比较，差异无统计学意义（χ2=0.532，P=0.765）。治疗后，2组NDS评分均低于治疗前，且观察组低于对照组；2组ADL和GOS评分均高于治疗前，且观察组均高于对照组，差异均有统计学意义（均P<0.05）。治疗后，2组肿瘤坏死因子α、C反应蛋白、白细胞介素6水平均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P<0.05）。结论 CT引导下血肿穿刺引流术中应用大剂量尿激酶治疗老年高血压脑出血的效果确切，能够改善患者生活能力以及预后水平，减轻患者炎性反应及神经功能损伤程度，且安全性较高。

• Objective To study the effect of different doses of urokinase on elderly patients with hypertensive cerebral hemorrhage during CT-guided hematoma puncture and drainage. Methods A total of 60 elderly patients with hypertensive cerebral hemorrhage who underwent CT-guided hematoma puncture and drainage in Zhangjiakou First Hospital, Hebei Province from June 2021 to October 2023 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 30 cases in each group. The control group was treated with low-dose urokinase, with a dose of 20 000 U. The observation group was treated with high-dose of urokinase, with a dose of 50 000 U. Both groups were treated for 2 weeks. The treatment effect, complications, neurological disability score (NDS), activities of daily living scale (ADL), Glasgow outcome scale (GOS) and inflammatory factor levels were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group ［96.7%(29/30) vs 73.3%(22/30)］(χ2=7.862, P<0.001). There was no significant difference in the incidence of complications between the two groups (χ2=0.532, P=0.765). After treatment, the NDS scores of the two groups were lower than those before treatment, and that of the observation group was lower than that of the control group; the ADL and GOS scores of the two groups were higher than those before treatment, and those of the observation group were higher than those of the control group (all P<0.05). After treatment, the levels of tumor necrosis factor-α, C-reactive protein and interleukin-6 in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P<0.05). Conclusions The application of high-dose urokinase in CT-guided hematoma puncture and drainage in the treatment of elderly hypertensive cerebral hemorrhage has a definite effect, which can improve the living ability and prognosis of patients, reduce the degree of inflammatory reaction and nerve function damage, and has high safety, which is worthy of clinical application.