脑室穿刺液化灌洗治疗重症脑室出血的临床观察

Therapeutic Effect of Ventricular Puncture Together with Lavage on Severe Ventricular Hemorrhage

目的探讨微创双侧脑室穿刺灌洗引流术联合腰大池穿刺脑脊液置换治疗重型脑室出血的治疗方法,观察其治疗效果。方法 52例经颅脑CT确诊的重症脑室出血患者,行双侧脑室微创穿刺外引流结合腰大池外引流术,术后进行双侧脑室低温0.9%氯化钠溶液和尿激酶灌洗。结果 52例患者有效31例,无效7例,死亡14例,病死率为27%。结论微创双侧脑室穿刺灌洗引流联合腰大池穿刺脑脊液置换治疗重型脑室出血,手术操作简便,不良反应少,治疗效果好,可明显缩短血性脑脊液引流时间;能提高患者的生存率,减少并发症和后遗症,改善生存质量。

Objective To study the method of Bilateral ventricle lavage and replacement of cerebrospinal fluid on severe intraventricular hemorrhage,and to observe the clinical effect.Methods 52 patients with severe intraventricular hemorrhage confirmed by CT scan underwent bilateral ventricle lavage and replacement of cerebrospinal fluid before bilateral ventricle was lavaged by hypothermic normal saline and urokinase.Results Among the clinical data of 52 patients,31 cases were effective,7 cases ineffective,14 cases died and the mortality was 27%.Conclusion Bilateral ventricle lavage and replacement of cerebrospinal fluid in the treatment of severe intraventricular hemorrhage is a safe and simple therapeutic technique,with few adverse effect and significantly reduced decannulation and BCSF drainage time.It can also increase the survival rate and improve patient＇s life quality and reduce the complications and sequela.