联合脑室体外引流及腰穿脑脊液置换术治疗全脑室出血32例

Treatment of all ventricular haemorrhage by extrinsic drainage through ventricle combining with substitution of CSFby lumbus puncture

目的：探讨治疗全脑室出血的方法。方法：采用脑室持续体外引流配合腰穿脑脊液置换治疗32例全脑室出血，选择积血较多一侧例脑室锥颅穿刺置管引流，并间断注入尿激酶，每1～2日行腰穿置换脑脊液，引流期间严格控制感染。结果：本组引流后症状明显改善，28例复查CT显示积血于4～14日消失。除4例死亡外，28例随访复查CT示脑室系统正常，仅2例未能独立行走，余均恢复良好。结论：本方法可清除导水管以上及以下的积血，明显降低病死率和提高生存质量。

Objective: To investigate the method for the treatment of haemorrhage of all ventricles. Methods:32 cases were treated by continuous extrinsic drainage through puncture of the lateral ventricle which accumulatedmore blood combining with substitution of CSF by means of lumbus puncture per 1-2 days. Urokinase was injectedinto ventricle at regular intervals. Infection was control strictly within the period of drainage.Results: The symptomswere improved. head CT were reexamined in 28 cases, which showed disappearance of hematocele in ventricle within4~14 days. Except for 4 cases of death, all 28 cases showed normal ventricle system on CT.2 cases can not walkindependently, rest of them all recovered from the disease. Conclusion: The hematocele above and below the duct inventricle can be eliminated by this method, and the mortality rate can be reduced greatly and the quality of survivalcan be improved.