第三脑室穿刺液化引流术治疗危重型自发性脑室出血

Clinical study on treating critical autonomy ventricular hemorrhage by ventricular drainage at third ventricle

目的研究应用第三脑室穿刺液化引流术治疗危重型自发性肿室出血的方法与疗效观察。方法依据脑室内积血的量及其形态、形状、病情、原发病，应用第三脑室穿刺液化引流术和／或辅以侧脑室液化引流术、脑脊液／生理盐水差额置换术，清除出血，抢救患者生命，改善预后。结果治疗53例，出院44例（基本痊愈13例，显著进步18例，进步9例，无变化4例），术后3个月内死亡12例（病死率22．6％）：门诊或家庭随访35例（6个月～7年），按日常生活活动（ADL）量表Barthel指数记分：ADLI 15例（42．9％），ADL Ⅱ10例（28．6％），ADL Ⅲ6例（17．1％），ADLⅣ3例（8．6％），ADLV1例（2．9％）。结论应用第三脑室穿刺液化引流术治疗危重型自发性脑室出血能最大限度地清除脑室出血，真正地实现微创，避免或减轻了并发症，有效改善预后，具有较大的优越性。

Objective To explore the method and the effectiveness of treating critical autonomyventrieular hemorrhage by ventricular drainage at third ventricle . Methods According to theamount of ventricular haematocele and its configuration, shape, symptom and the primary affection, clearing the hemorrhage by liquefied drainage eentesis at diacele, with the assistant of liquefieddrainage, centesis at lateral ventricle and balancing between eerebrospinal fluid and physiological saline. Results The cerebral hemorrhage were cleared in 53 case of this group： 44 discharged（ 13 cases cured, 18 cases apparent improved, 9 cases improved, 4 cases no change）, 12 cases died in 3 months, death rate was 22.6% ; 35 cases had clinical or home follow - up for 6 months to 7 years. They were evaluated with Barthel index score： ADLI15cases （42.9 % ） ; ADL Ⅱ 10cases （28.6%） ; ADL Ⅲ 6cases（ 17.1% ） ： ADLⅣ3cases （8. 6%）; ADLVlcase（2.9%）. Conclusion Treating critical autonomy ventricular hemorrhage by ventricular drainage at third ventricle could clear the bleeding minimal invasively with less complications and improved prognosis.