重组链激酶在重度脑室内出血外科治疗中的应用

The local use of recombinant streptokinase in surgical treatment of severe intraventricular hemorrhage.

目的研究重组链激酶（ｒＳＫ）在脑室内出血治疗中的应用。方法对１５例重度脑室内出血（ＩＶＨ），于发病后１６小时内进行双侧或单侧脑室外引流术，并辅以ｒＳＫ脑室内纤溶治疗。结果ＣＴ复查示，１４例于术后４日脑室内积血减少约６０％，７例积血１周内完全消失，７例于２周内消失，１例死亡，随访１３例中优良１１例，脑积水３例行脑室腹腔分流术。结论早期脑室外引流及应用ｒＳＫ纤溶治疗重度ＩＶＨ效果良好，无明显副反应发生。

s Objective The local use of recombinant streptokinase (r SK) in the treatment of severe intraventricular hemorrhage (IVH) was studies. Methods Fifteen cases with severe intraventricular hemorrhage were treated with r SK injected into the lateral ventricle followed by ventricular drainage which was performed within 16 hours after onset. A total dose of r SK was 15 mg in each case.Results CT showed that the ventricular clots of 14 cases were decreased about 60 percent at 4th day after treatment. There were 7 cases whose ventricular clots disappeared on the CT scan the first week after the treatment and another 7 cases clots disappeared after two weeks. Only one patient died. In follow up 11 of 13 pationts showed excellent or good recovery. Three patients developed hydrocephalus and got ventricular peritoneal shunt. There were no hemorrhage, infection or other complications after the treatment with r SK.Conclusions The treatment may contribute to an improvement of prognosis for the patients with severe IVH.