脑室出血96例临床治疗

Clinical treatment of cerebroventricular hemorrhage in 96 cases

目的 总结原发性及继发性脑室出血治疗经验,并探讨其适宜治疗方法。方法 对96例原发性及继发性脑室出血病人,分别采用单纯内科治疗（A组）、行腰穿脑脊液置换治疗（B组）、行侧脑室穿刺引流及尿激酶注入并冲洗治疗（C组）及行上述B、C两组治疗相结合（D组）的方法,观察其疾病转归、脑积水、颅内感染及再出血的发生率、积血清除时间加以统计分析。结果 C组较A、B组积血清除时间缩短、脑积水发生率减低（P〈0.05）;D组较A、B组有效率提高、积血清除时间缩短、脑积水发生率减低（P〈0.05）,较A组病死率降低（P〈0.05）。结论 行侧脑室穿刺引流冲洗治疗及侧脑室穿刺引流冲洗结合腰穿脑脊液置换治疗效果优于单纯内科治疗及行腰穿脑脊液置换治疗,且以侧脑室穿刺冲洗引流结合腰穿脑脊液置换效果最佳。

Objective To summarize the treatment experience of idiopathic or insecondary cerebroventricular hemorrhage and to discuss the suitable management. Methods The clinical data of 96 patients with idiopathic or insecondary cerebroventricular hemorrhage were treated respectively with different management such as simple medical treatment （group A ）, to perform lumbar puncture and C. S. F replacement （group B）, to perform lateral external （ group A）, to perform lumbar puncture and C. S. F replacement （ group B）, to perform lateral external ventricular drainage and infusion of urokinase with irrigation （ group C） , to perform the treatment of above group A in combination with group B. To observe prognosis of disease, the incidence of hydrencephalus, intracranial infeion and rehaemorrhagia, the hematocele cleared time, then to make statistical analysis. Results The hematocele cleared time was shorter and the incidence of hydrencephalus was lower in group C than in group A and B （ P 〈 0.05 ）. The effective power hematocele was higher, the hematocelecleared time was shorter and the incidence of hydrencephalus was lower in group D than in group A and B （ P 〈 0. 05 ） , and the case fatality was lower in group D than in group A （ P 〈 0.05 ）. Conclusion To perform lateral external ventricular drainage and infusion of urokinase with irrigation and to perform lateral external ventricular drainage and infusion of urokinase with irrigation in combination with lumbar puncture and C. S. F replacement are more effective than simple medical treatment and to perform lumbar puncture and C. S. F replacement. Furthermore,to perform lateral external ventricular drainage and infusion of urokinase with irrigation in combination with lumbar puncture and C. S. F replacement is the most effective management.