侧脑室前后角微创穿刺尿激酶引流治疗脑室出血的临床分析

Clinical analysis of puncture via posterior horn and anterior horn of lateral ventricle combined with urokinase drainage in treating cerebral hemorrhage

目的探讨微创手术治疗脑室出血的新方法。方法应用YL-1型血肿微创穿刺针于侧脑室前、后角穿刺尿激酶引流治疗脑室出血31例，以传统颅骨钻孔脑室外引流治疗同类疾病30例为对照组，对2者疗效进行比较。结果微创穿刺组手术时间平均33min；18例单、双侧脑室血肿清除90％以上；其余13例血肿清除50％-90％，术后明显好转和好转25例，与对照组相比血肿清除效率、好转率差异有统计学意义（均P〈0．01）。结论应用YL-1型血肿微创穿刺针于侧脑室前、后角穿刺尿激酶引流治疗脑室出血，具有创伤小、清除积血迅速、缩短脑室出血后继发性病理损害过程、减少并发症、降低病死率等优点，是行之有效的手术方法。

Objective To compare the different ways of minimally invasive operation for treating cerebral hemorrhage. Methods YL-1 hematoma minimally invasive puncture combined with urokinase drainage via posterior and anterior horn of lateral ventricle was carried out in 31 cases of cerebral hemorrhage. 30 other cases were treated by traditionally external ventricular drainage of craninal drilling. The operating time for minimally invasive group was 33 minutes on average. Results The clearance of lateral and unilateral ventricle hematoma was 90% in 18 cases, which was 50-90% in the other 13 cases. After operation,25 cases improved significantly,with significant difference between the groups（P 〈0.01 ）. Conclusion YL-1 hematoma minimally invasive puncture combined with urokinase drainage via posterior and anterior horn of lateral ventricle is a feasible way for treating cerebral hemorrhage, with small trauma, quick clearance of hematoma, shortening the course of secondary pathologic damage, decreasing complications and mortality.