脑室系统出血66例临床分析

Clinical analysis of 66 cases of intraventricular hemorrhage

目的：探讨脑室系统出血治疗方法及预后。方法回顾性分析66例脑室系统出血患者临床资料，其中A组36采用经双侧侧脑室外引流＋尿激酶（ UK）脑室内纤溶治疗＋腰椎穿刺引流，B组30例采用双侧侧脑室外引流＋尿激酶脑室内纤溶治疗。改良Rankin评分评估患者病情预后，术后多次行头颅CT检查血肿影像学变化。结果脑室出血清除时间A组为（5．3±1．5）d，B组为（8．2±2．5）d，两组差异有统计学意义（t＝-5．820，P＝0．000）。 A组有效率为83．3％（30/36），B组有效率为66．7％（20/30），两组差异没有统计学意义（χ2＝2．475，P＝0．116）。结论脑室系统出血患者同时给予双侧侧脑室外引流＋尿激酶脑室内纤溶治疗＋腰椎穿刺引流效果较好。

Objective To explore treatment methods and prognosis of external ventricular drainage .Methods A retrospective analysis of 66 cases with severe intraventricular hemorrhage patients were selected ,36 cases underwent bilateral ventricle drainage and urokinase （ UK ） intraventricular fibrinolysis therapy ＋terminal cistern drainages , 30 cases with bilateral ventricle drainage and urokinase for intraventricular fibrinolysis .The prognosis of the patients with modified Rankin Scale score was assessed .After multiple cerebral CT examination hematoma imaging changes were observed.Results A group of intraventricular hemorrhage clearing time （5.3 ±1.5）d,B group of intraventricu-lar hemorrhage clearing time （8.2 ±2.5）d,there was significant difference （t=-5.820,P=0.000）.Rate in group A was 83.3%（30/36）,group B was 66.7%（20/30）, there was no significant difference （χ2 =2.475,P=0.116）. Conclusion This study suggests that intraventricular hemorrhage were given bilateral ventricle drainage and uroki -nase for intraventricular fibrinolysis therapy ＋terminal cistern drainages effect is better .