微创脑室引流对蛛网膜下腔出血的治疗

Treatment of Subarachoid Hemorrhage with Microinvasive Ventricular Drainge

目的 :探讨蛛网膜下腔出血实用、有效的外科治疗方法及机理。方法 :对外伤性及自发性蛛网膜下腔出血的 97例 ,在床边锥颅置管行微创脑室引流。术前准备后局麻下操作 ,置引流管于侧脑室内 ,持续外引流。术后记录每日脑脊液的引流量 ,观察患者意识、头痛和脑膜刺激征的变化。复查 CT,了解脑梗塞和脑积水的发生率。结果 :微创脑室引流一般在 10～ 15 min内完成 ,死亡率为 14 .4 %。接受该法治疗的患者血性脑脊液廓清快 ,头痛症状缓解明显且程度较轻 ,脑膜刺激征持续时间短 ,脑梗塞和脑积水的发生率低。结论 :对蛛网膜下腔出血行微创脑室引流有利于改善预后 ,应积极施行。

Objective:To explore the surgical treatment method and mechanism of pratice and effectiveness in subarachnoid hemorrhage.Methods:97 patients of trauma and spontaneous subarachoid hemorrhage were operated the microinvasive ventricular drainage by punching skull and placing tube beside bed. The operation was performed in local anaesthesia after preoperation preparation. The tube was put into ventricular and the drainage was continued. The drain volume of cerebrospinal fluid was recorded postoperation everyday. The alteration of consciousness, cephalalgia and meningeal irration symptom were observed. CT was reexamined in order to understand the incidence rate of cerebral infarction and hydrocephalus.Results:The mortality was 14.4% in the cases. The bloody cerebrospinal fluid of the patients who received the treatment cleaned fastly, the symptom of cephalagia remissed obviously and the degree was moreslight. The duration of meningeal irration symptom was short. The incidence rate of cerebral infarction and hydrocephalus was lower.Conclusion:It′s favorable for the patients of subarachoid hemorrhage to improve prognosis in microinvasive ventriculsr drainage. The methods should be performed activity.