摘要
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可行性。方法总结900例颅骨钻孔结合尿激酶微创治疗外伤性硬膜外血肿的临床资料。结果术前血肿量≤30ml297例，31～60ml405例，1〉61ml198例；每次尿激酶用量为2—6万Iu，其中：2万Iu99例，3万IU234例，4万IU324例，5万IU198例，I〉6万Iu45例；尿激酶使用次数为：2次／d747例，3次／d153例；术后轴位CT扫描动态观察硬膜外血肿显示：7天内完全消退并解除占位效应855例；GOSV级810例，≤Ⅳ级90例。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 discuss the feasibility of minimally invasive treatment of traumatic epidural haema- toma with drilling skull plus urokinase. Methods Totally 900 patients with traumatic epidural haematoma who were treated with drilling skull plus urokinase were reviewed. Results Epidural haematoma volume before opera- tion was ~〈30ml in 297 patients,31 - 60ml in 405 patients, and t〉 61 ml in 198 patients. Haematoma aspiration was followed by instillation of urokinase （ 20 000 to 60 000 IU） , including 20 000 IU in 99 patients, 30 000 IU in 234 patients,40 000 IU in 324 patients,50 000 IU in 198 patients,≥60 000 IU in 45 patients respectively. Postopera- tively the injection was repeated two times per day in 747 patients, three times per day in another 153 patients. Post- operative axial CT scan revealed that the hematoma was completely evacuated within 7 days in 855 patients. Ac- cording to the Glasgow outcome score, 810 patients were Grade V, 90 patients ≤ IV. Conclusion Drilling skull plus urokinase for treatment of traumatic epidural haematoma is a safe and effective method, based on correctly grasping the indications and contraindications of surgery.
出处
《创伤外科杂志》
2009年第4期299-301,共3页
Journal of Traumatic Surgery
关键词
硬膜外血肿
颅骨钻孔
尿激酶
traumatic epidural haematoma
drilling skull
urokinase
