基底节区脑出血破入脑室并发脑积水的手术治疗的疗效观察

Observation on the Curative Effect of Surgical Treatment of Basal Ganglia Hemorrhage Breaking into Ventricles and Hydrocephalus

目的探讨手术治疗基底节区脑出血破入脑室病发脑积水的疗效。方法对40例基底节区脑出血破入脑室病发脑积水的患者分组,按照不同的手术方式分为实验组和对照组,实验组12例,对照组28例,分别实施不同的手术治疗,对比治疗疗效。结果实验组12例患者颅内血肿全部清除,且脑积水得到缓解,有2例患者出现术后并发症。对照组28例患者中术前1例死亡,2例放弃治疗,有8例患者CT结果显示扩张脑室变小,3.4室部分变得畅通,且脑积水缓解;9例患者脑积水无缓解,3.4脑室仍然显示闭塞,经脑室外引流,才得到缓解;有8例患者出现术后并发症。实验组患者的血肿清除率、脑积水缓解率等显著优于对照组(P<0.05)。术后3个月对患者经随访,术后生活能力对比结果显示,实验组显著优于对照组(P<0.05),差异具有统计学意义。结论脑内血肿清除联合脑室引流脑脊液治疗基底节区脑出血破入脑室病发脑积水的创伤小、效果佳,值得推广应用。

Objective to explore the curative effect of surgical treatment of hydrocephalus caused by intraventricular hemorrhage in basal ganglia region. Methods 40 cases of hydrocephalus caused by intracerebral hemorrhage in basal ganglia region were divided into experimental group and control group according to different surgical methods, 12 cases in the experimental group and 28 cases in the control group. Different surgical treatments were performed and the curative effect was compared. Results all 12 patients in the experimental group were cleared of intracranial hematoma, and hydrocephalus was relieved. Postoperative complications occurred in 2 patients. Among the 28 patients in the control group, 1 died before surgery and 2 gave up treatment. CT results of 8 patients showed that the expanded ventricles were smaller, and parts of the 3 and 4 compartment were unblocked, and hydrocephalus was relieved. Hydrocephalus was not relieved in 9 patients. 3.4 the ventricles were still occluded and were relieved by external drainage. Complications occurred in 8 patients. The hematoma clearance rate and hydrocephalus remission rate of the experimental group were significantly higher than those of the control group (P<0.05). Patients were followed up for 3 months after surgery, and the results of comparison of postoperative living capacity showed that the experimental group was significantly superior to the control group (P<0.05), with statistically significant differences. Conclusion the treatment of intracerebral hematoma clearance combined with intraventricular drainage with cerebrospinal fluid in the treatment of intraventricular hemorrhage in the basal ganglia region and hydrocephalus caused by intraventricular hemorrhage is less traumatic and effective, and is worthy of popularization and application.