手术时机对重型脑室出血患者神经功能的影响

Effects of operation opportunity on neurological function in patients with severe intraventricular hemorrhage

目的:探讨脑室微创穿刺引流并脑脊液置换治疗重型脑室出血的手术时机对患者预后神经功能的影响。方法:选择不同的手术时机对重型脑室出血患者行脑室微创穿刺引流并脑脊液置换术,对照分析其临床神经功能缺损程度、总有效率、基本痊愈率、病死率和住院天数。结果:A组(超早期)、B组(急性期)和C组(亚急性期)3组治疗后临床神经功能缺损程度评分较治疗前均有显著降低,差异有显著性意义(P<0.05);治疗后A、B两组的临床神经功能缺损程度评分低于C组,A、B两组的基本痊愈率、总有效率均显著高于C组,而死亡率低于C组,A、B两组脑脊液恢复正常时间、住院天数较C组明显缩短,差异具有显著性意义(P<0.01),而A、B两组间差异无显著性意义(P>0.05)。结论:重型脑室出血患者在24h内行脑室微创血肿清除并脑脊液置换手术,同时进行早期康复治疗,可以有效地降低病死率,提高治愈率,减轻临床神经功能缺损程度,对患者的临床神经功能恢复有帮助。

Objective：To explore the effect of the operation opportunity on neurological function of the brain-ventricle drainage combined with cerebrospinal fluid replacement on the patient with severe intraventricular hemorrhage. Method：88 subjects with the brain-ventricle drainage combined with cerebrospinal fluid replacement were randomly divided into hyper-morning group （group A）,acute stage group（group B） and subacute stage group（ group C）. The clinical neurological function disorders were recorded in the patient of the three groups before treating or after treating. The variation of neurological function was cross-check analyzed and compared among total effective rate, near recovery rate,mortality rate and hospital days. Result：after 1 month treatment,the mark of clinical neurological function disorder was decreased in the three groups （P〈0.05）.The total effective rate and near recovery rate of Group A and B were significantly higher than group C. The mark of clinical neurological function disorder and mortality rate of group A and B were lower than group C （P〈0.01）. The cerebrospinal fluid normal time,hospital days of group A and B were obviously lower than group C （P〈0.01）. However,there was no significant differences between group A and group B （P〉0.05）. Conclusion：The brain-ventricle drainage combined with cerebrospinal fluid replacement in 24h and early rehabilitative intervention 10 days after surgery are able to reduce mortality rate,increase healing rate,lessen clinical neurological function disorder and promote the recovery of the neurological function. Thus,this would be a good choice of treating severe intraventricular hemorrhage.