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目的探讨颅骨钻孔结合尿激酶微创治疗外伤性硬膜外血肿的疗效。方法对外伤性急性、亚急性及慢性硬膜外血肿患者,选取部分病例在血肿最厚层面采用颅骨钻孔,置12～14号硅胶管入血肿腔,并用尿激酶血肿腔内注射后引流,观察疗效并加以总结。结果 30例患者均一次穿刺成功,术前、术后硬膜外血肿量经配对t检验,t=17.87,P<0.01,差异具有统计学意义;术前、术后GCS评分采用配对比较的秩和检验,P<0.01,差异具有统计学意义;术前血肿量与GCS评分采用Spearman相关分析,r=-0.065,P=0.753,无统计学相关关系;术后血肿量与GCS评分采用Spearm an相关分析,r=0.148,P=0.436,差异无统计学意义。结论正确把握硬膜外血肿的手术适应证和禁忌证,颅骨钻孔结合尿激酶微创治疗硬膜外血肿是一种简单、安全而有效的手段。
Objective To investigate the effect of skull drilling combined with urokinase minimally invasive treatment of traumatic epidural hematoma. Methods In acute traumatic, subacute and chronic epidural hematoma patients, some cases were selected by cranial drilling at the thickest level of hematoma. Silicone tubes 12 to 14 were placed into the hematoma cavity and injected with urokinase hematoma after intracavitary injection. Observed the effect and summarized. Results Thirty patients were successfully punctured at one time. The preoperative and postoperative epidural hematoma volume was paired t-test (t = 17.87, P <0.01), and the difference was statistically significant. Preoperative and postoperative GCS scores were matched by rank And test, P <0.01, the difference was statistically significant; preoperative hematoma and GCS score using Spearman correlation analysis, r = -0.065, P = 0.753, no statistical correlation; postoperative hematoma and GCS score by Spearm an Correlation analysis, r = 0.148, P = 0.436, the difference was not statistically significant. Conclusion Correct grasp of surgical indications and contraindications of epidural hematoma, skull drilling combined with urokinase minimally invasive treatment of epidural hematoma is a simple, safe and effective means.