尿激酶灌注术治疗脑室内出血的疗效及风险分析

Effect and risk of drainage and urokinase perfusion in intraventricle hemorrhage

目的探讨双侧侧脑室外引流/尿激酶灌注治疗脑室内出血的临床疗效及风险。方法34例脑室内出血患者,GCS<8分者9例,GCS8￣10分者15例,GCS11￣15分者10例,均采用双侧脑室外引流/尿激酶灌注,引流、溶解脑室内血凝块,辅以扩张脑血管、营养脑细胞等综合治疗。结果存活26例(76.47%);再出血3例(8.8%)。死亡6例(17.6%),放弃治疗2例。存活的26例患者中4例因脑积水行脑室-腹腔分流术。结论脑室内出血的治疗重点在于尽早清除脑室内血肿、疏通脑室梗阻,脑室外引流和尿激酶灌注是治疗脑室内出血的有效措施,但存在再出血的风险。

[Objective] To investigate the effect and risk of drainage and urokinase perfusion in intraventricle hemorrhage. [Method] 34 patients with intraventricle hemorrhage （GCS of 9 cases was lower than 8,GCS of 15 cases varied from 8 to 10,GCS of 10 cases fluctuated from 11 to 15）, were undertakern external ventricular drainage and urokinase perfusion with the combined therapy of dilating cerebral vessels and brain cell nutrition. [Results] Among the 34 patients mentioned above 2 cases gave up treatment, The survival, rehaemorrhagia and death rate were 76.4% （26/34）, 8.8%（3/34） and 17.6%（6/34） respectively. 4 survived cases were undertakern ventriculo-pefitoneal shunt owing to dropsy of brain. [Conclusion] Ventricle drainage and urokinase perfusion are an effective method for the treatment of intraventricle hemorrhage with the risk of rehaemorrhagia.