侧脑室外引流加尿激酶冲洗治疗脑出血破入脑室32例

External ventricular drainage and urokinase irrigation treatment for cerebral hemorrhage of breaking into the ventricle(32 cases)

目的探讨脑室内出血的治疗方法及其外科治疗效果。方法对32例脑室内出血患者,29例采用双侧侧脑室外引流术,3例行开颅血肿清除+血肿侧侧脑室外引流,所有患者均行尿激酶灌注治疗及腰穿释放脑脊液。结果 32例中ADL1(恢复正常)11例,ADL2(生活自理)8例,ADL3(需人帮助)5例,ADL4(卧床不起)2例,ADL5(植物状态)2例,死亡4例。结论侧脑室外引流治疗脑室出血可及时缓解颅高压;术后通过尿激酶灌注治疗及腰椎穿刺释放脑脊液可有效缩短引流时间,尽早清除脑室内积血,可取得较为理想的治疗效果。

Objective To approach ways to treat intraventricular hemorrhage and to evaluate the effect of surgical treatments. Methods A total of 32 individuals with intraventrieular hemorrhage were evaluated, 29 participants underwent two-side drainage in the treatment of intraventricular hemorrhage, 3 participants underwent craniotomy hematoma removal and intraventricular external drainage in the hematoma side. All participants were treated by urokinase infusion therapy and underwent lumber puncture releasing cerebrospinal fluid. Resuits Among all the cases, ADLl（reeovery）：ll cases, ADL2（with self care ability）：8cases, ADL3（with help）：5cases, ADL4（being bedridden）：2 eases, ADL5 （vegetative state）：2 cases, death： 4cases. Conclusion Significant decreases in intracranial pressure were observed after lateral ventricle external drainage. Postoperative urokinase infusion therapy and releasing cerebrospinal fluid shorten the process and can exert better effects on removing intraventricular hemorrhage as early as possible.