21例外伤性脑室内出血治疗分析

Clinical analysis on the treatment of 21 cases of traumatic intraventricular hemorrhage

目的总结探讨外伤性脑室内出血的临床治疗方法。方法采用额角常规钻孔脑室外引流+尿激酶溶血。结果治疗后半年GOS评分,良好10例,中残5例,重残3例,死亡3例。结论尽早脑室外引流解除血肿对脑室壁压迫,改善脑微循环与脑脊液循环是脑室内出血救治成功的关键;尿激酶灌注治疗能快速、安全、有效溶解血肿,排出积血。

Objective To discuss the clinical treatment for traumatic intraventricular hemorrhage. Methods Twenty-one cases of traumatic intraventricular hemorrhage were treated with the combined therapy of external ventricular drainage with conventional drilling through one frontal angle and thrombolytic therapy by urokinase. Results Half a year after treatment, the therapeutic outcomes according to GOS scores in these 21 cases were as follows： 10 of them were fine, 5 moderately disabled, 3 seriously disabled, and 3 dead. Conclusion Draining blood clots out of ventricles must be conducted as early as possible in order to relieve the pressure against ventricle walls, thereby ameliorating microcirculation of the brain and cerebrospinal fluid circulation and improving the prognosis. In addition, the filling of urokinase is greatly beneficial for dissolving hematoma in ventricles rapidly, effectively and safely, so as to facilitate discharging the hematoma.