双侧脑室插管尿激酶持续冲洗及腰池引流治疗重度脑室出血

Treatment of severe ventricular hemorrhage by continuous irrigation of urokinase under bilateral ventricular intubation and drainge of lumbar cisterna

目的 :探讨重度脑室出血的治疗方法 ,降低重度脑室出血的死亡率。方法 :对重度脑室出血的病例行双侧脑室插管尿激酶持续冲洗及腰池持续引流治疗。结果 :本组23例重度脑室出血病人 ,存活率87 %(20/23) ,死亡率13 % (3/23) ,2例病人因交通性脑积水行脑室腹腔分流。CT显示三、四脑室内血肿清除时间2～5天 ,平均3天。结论 :及早疏通脑室系统梗阻是脑室出血的治疗关键 ,双侧脑室插管尿激酶持续冲洗及腰池引流治疗重度脑室出血是一种积极有效的方法。

Objective:To study the curative method of severe ventricular hemorrhage,so as to reduce the mortality of severe ventricular hemorrhage.Methods:All patients with severe ventricular hemorrhage in this group were treated by continuous irrigation of urokinase under bi lateral ventricular intubation and drainage of lumbar cisterna.Results:There were23cases with severe ventricular hemorrage in this group,the survival rate was87%(20/23),the mortality was13%(3/23).The shunt of cerebral ventricle and abdominal cavity was performed in2cases due to communicating hydrocephalus.The clearance time of hematoma in three and four cerebral ventricles displayed by CTwas2to5days,the average time was3days.Conclusion:Dredging the obstruction of ventricular system as soon as possible is the key to treat ventricular hemorˉrhage.Continuous irrigration of urokinase under bilateral ventricular intubation and drainage of lumbar cisterna is a positive and effective method for treating severe ventricular hemorrhage.