双侧脑室穿刺联合腰大池引流在治疗高血压脑出血脑室铸型患者中的时机选择

The timing of bilateral ventriculopuncture combined lumbardrainage to cure the patients with hypertensive cerebral hemorrhage of intraventricular hemorrhage of casting form

目的探讨不同手术时机运用微创穿刺引流术治疗高血压脑出血的效果。方法将采用双侧脑室穿刺联合腰大池引流术治疗的68例高血压脑出血患者作为研究对象，比较超早期与延迟期实施手术的疗效，并分析造成差异的原因。其中超早期（6h内）实施手术34例，延迟期（6～72h）实施手术34例，比较术后近期（1个月）和远期随访（6个月）的疗效。结果术后近期（1个月）和远期（6个月）随访预后差异有统计学意义，超早期组病例近远期好转率均明显高于延期组（P〈0．05）。结论对于有手术适应证的脑出血脑室铸型患者，应尽可能在6h内行双侧脑室穿刺加腰大池引流术，超早期实施手术可明显提高患者生存质量。

Objective To explore the curative effects of minimally invasive surgical drainage for hypertensive cerebral hemor- rhage in the different timing. Methods 38 cases of hypertensive cerebral hemorrhage treated with bilateral ventriculopuncture combined lumbardrainage were used as the research objects. The curative effects in ultraearly period and delayed period were compared,and the reason for the differences was analyzed. Among them, there were 15 cases who were undergoing surgery in ultra -early period （within 6hrs） ,and 23 cases in delayed period （6 - 72hrs）. The curative effects between recent postoperative period （within 1 month） and long -term follow up （6 months） were compared. Results There were significant difference between recent postoperative period （within 1 month） and long -term follow up （6 months）, and improvement rate was obviously higher in ultra -early period group than were in delayed period group （P 〈 0.05 ）. Conclusion Bilateral ventriculopuncture combined lumbardrainage should be performed for the patients with the indication of cerebral hemorrhage intraventricular hemorrhage of casting form as soon as possible within 6hrs. It is indicated that surgery performed in ultra- early period can improve the patients＇life quality.