改良式侧脑室联合腰大池持续交替引流在脑室出血中的应用

Treatment of intraventricular hemorrhage by improved external ventricular drainage combined with lumbar cisternal drainage

目的探讨改良式侧脑室联合腰大池持续交替引流术治疗脑室出血的临床疗效。方法将98例脑室出血患者随机分成2组,改良组(50例)采用改良式侧脑室联合腰大池持续交替引流术,传统组(48例)采用单纯侧脑室引流或结合腰椎穿刺术,比较两组的临床疗效。结果改良组脑室内积血清除速度明显快于传统组(P<0.01)。改良组6例(12.0%)发生梗阻性脑积水,4例(8.0%)死亡;传统组13例(27.1%)发生梗阻性脑积水,9例(18.8%)死亡,两组均无颅内感染病例;改良组疗效明显优于传统组(P<0.05)。结论改良式侧脑室联合腰大池持续交替引流术治疗脑室出血可明显降低病死率和伤残率,减少并发症和后遗症,改善预后,优于传统技术和方法。

Objective To study the clinical results of improved external ventricular drainage combined with lumbar cisternal drainage in treating intraventricular hemorrhage. Methods Ninty-eight cases of intraventricular hemorrhage were divided into two groups randomly. One group（ called improved group）cases were treated by persistent interchange external ventricular drainage combined with lumbar cisternal drainage, and the other group （ called traditionary group） cases with external ventrieular drainage or combined with lumbar puncture. All the clinical results were studied retrospectively. Results In improved group, 6 cases （ 12. 0% ） had obstructive hydrocephalus and 4 cases（8.0% ） died, compared with 13 cases（27.1% ） and 9 cases（ 18.8% ） in traditonary group respectively. In all cases, no intracranial infection was observed. Totally, the ctinicl effica- cy of improved group cases was significantly better than that of the traditionary one （ P 〈 0. 05 ）. Conclusion Treating intraventrieular hemorrhage by improved external ventricular drainage combined with lumbar cisternal drainage, compared to traditionary methods, is associoated with decreaesed morbility and mortality,and can reduct complications and improve prognosis.