尿激酶联合CT引导穿刺引流术治疗基底节区高血压脑出血患者的疗效及安全性分析

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【关键词】尿激酶；CT引导；穿刺引流术；基底节区高血压脑出血；疗效；安全性【中图分类号】 R651.1+1 【文献标志码】 B 【文章编号】1672-7770（2025）03-0314-06

Abstract：ObjectiveTo explore the therapeutic eficiencyand safety profile of a combination therapy involving urokinase and CT-directed puncturedrainage for managing basal ganglia hypertensive cerebral hemorrhage.Methods A total of96 individualssuffring from hypertensivecerebralhemorrhage inthebasal ganglia，who were treated at CT Room of Zhangjiakou First Hospital from January 2O22 to December 2O23 were enroled.These patients were randomly dividedinto control group and experimental group，with an equal numberof 48 participants ineach. Traditional craniotomywas the treatmentapproach forthecontrol group，whereas the experimental groupreceived CTguided puncture and drainage with adjunctive urokinase. The outcomes of the two groups were compared，including therapeutic outcomes，postoperative recuperation measuredby hematoma resolutionrate，time to spontaneous opening，cerebral edema volume oneweek post-surgery，and Glasgow coma scale（GCS），stress-related tumor indices，including adrenocorticotropic hormone（ACTH）and serum cortisol（Cortisol，ACTH，Cor），and therateof complications，such asrebleeding，gastrointestinal bleeding，intracranial infection，pulmonary infection，seizures， and brain herniation.ResultsTheexperimental group demonstrateda superior total eficacy ratecompared to the control group（ P<0.05 ）．Additionally，this group exhibited reduced self-opening times and postoperative cerebral edema volumes at one week，along with increased hematoma resolution rates and GCS scores one week post-surgery， when contrasted with the control group（ P<0. 05 ）.Post-treatment，both groups showed elevated levels of stressrelated tumor indices，but the experimental group had lower levels compared to the control group（ P<0. 05 ）. Moreover，the experimental group experienced a lower incidence of adverse events than the control group（ P<0.05 ）

ConclusionsThe therapeutic approach combining urokinase with CT-guided puncture and drainage for treating basal ganglia hypertensive cerebral hemorrhagepatientsisproved tobeclinicallefective.Itenhances postoperative recovery，mitigatespostoperative stress responses，improves patient prognosis，and exhibitsahigh levelof safety， thus warranting wider adoption and consideration.

Key words：urokinase；CT guidance；puncture drainage；hypertensive cerebral hemorrhage in basal ganglia; urative effect； safety

高血压脑出血在神经外科是十分常见的急危重症，随着人口老龄化发展、不良饮食及生活习惯的增加、生活压力的加剧，此病症的发病率常年居高[1]。（剩余11960字）