脑室出血铸型22例临床分析

Analysis of 22 patients with ventricular hemorrhage cast

目的评价脑室外引流治疗或联合开颅脑内血肿清除术治疗脑室出血铸型的效果。方法对2006-01~2010-12收治的22例脑室出血铸型患者的临床资料进行回顾性分析。结果术后随访6个月,开颅脑内血肿清除加去骨瓣减压术联合脑室外引流治疗9例,死亡6例,存活3例中ADL I级2例,ADLⅢ级1例;原发血肿穿刺加脑室外引流治疗4例,死亡2例,存活2例中ADL I级1例,ADLⅣ级1例;单纯脑室外引流治疗4例,死亡3例,存活1例ADL I级;腰穿治疗2例中,ADLI级1例,ADLⅤ级1例;脑动静脉畸形切除加血肿清除2例,ADL I级;脑室镜下血肿清除术1例,ADL I级。结论开颅脑内血肿清除联合脑室外引流术治疗全脑室出血铸型效果较好,且病死率和并发症均较低,值得临床推广应用。

Objective To evaluate the efficacy of the ventriculopuncture with craniectomy in the treatment of massive ventricular hemorrhage casting.Methods Clinical data of 22 cases of ventricular hemorrhage cast patients from January 2006 to December 2010 were retrospectively analyzed.Results Followed up 6 months after operation,9 cases treated by decompressive craniectomy with ventriculopuncture,6 cases died,3 cases survived,including ADL Ⅰ grade 2 cases,ADL Ⅲ grade 1 case;4 cases treated by primary hematoma puncture with ventriculopuncture,2 cases died,2 cases survived,including ADL I grade 1 case,ADL Ⅳgrade 1 case;4 cases treated by simple ventriculopuncture,3 cases died,1 case survived,ADL Ⅰ grade;2 cases treated by lumbar puncture,ADL Ⅰ grade 1 case,ADL Ⅴ grade 1 case;2 cases treated by brain AVM and hematoma removal,ADL Ⅰ grade 2 cases;1 case treated by hematoma removal under ventriculoscope,ADL Ⅰ grade.Conclusion The craniectomy with ventriculopuncture is effective in treating ventricular hemorrhage cast.It can reduce the mortality and the incidence of complications.