摘要：

目的 探讨血肿穿刺置管引流术联合血肿腔内注射尿激酶治疗慢性硬膜下血肿的疗效。方法 共 86 例慢性硬膜下血肿患者行单侧或双侧、单孔或多孔血肿穿刺置管引流术，采取术中不冲洗、术后血肿腔内注射尿激酶（20 ×10³ U/次、2 次/d）的方法，计算治愈率，记录并发症（包括颅内出血和感染）发生率和复发率。结果 手术时间平均（0.60 ± 0.16）h；注射尿激酶 3 d 后脑组织均复位；平均随访（4.00 ± 0.22）个月，治愈 85 例、治愈率为 98.84%，复发 1 例、复发率为 1.16%；无一例发生术后颅内出血、感染或需再次手术。结论 血肿穿刺置管引流术术中不冲洗、术后血肿腔内注射尿激酶治疗慢性硬膜下血肿，效果显著，复发率较低。

关键词: 血肿, 硬膜下, 慢性, 引流术, 尿纤溶酶原激活物

Abstract:

Objective To explore the curative effect of hematoma puncture and catheter drainage combined with urokinase injection in the surgical treatment of chronic subdural hematoma. Methods A total of 86 patients with chronic subdural hematoma were treated with unilateral or bilateral, single hole or mutilhole hematoma puncture and catheter drainage. Intraoperative washing was not done, and urokinase (20 × 10³ U/time, twice one day) was injected into the cavity of hematoma after operation. The cure rate was calculated. Postoperative complications (intracranial bleeding and infection) and the recurrence rate were recorded. Results The average operation time was (0.60 ± 0.16) h. Brain tissue was restored 3 d after injection of urokinase. The average follow-up period was (4.00 ± 0.22) months. There were 85 cases being cured, and the cure rate was 98.84%. One case was recurred, and the recurrence rate was 1.16%. No patient had postoperative intracranial bleeding or infection, or needed reoperation. Conclusions Chronic subdural hematoma can be treated by hematoma puncture and catheter drainage with no intraoperative washing but urokinase injection into the cavity of hematoma after operation, which had remarkable effect
and low recurrence rate.

Key words: Hematoma, subdural, chronic, Drainage, Urinary plasminogen activator