超声波引导侧脑室刺穿引流治疗早产儿颅内出血后脑积水临床观察

Clinical Observation of Ultrasound Guided Puncture Drainage of Lateral Ventricle Hydrocephalus after Treatment of Posthaemorrhagic Hydrocephalus in the Premature

目的：探讨超声波引导侧脑室刺穿引流治疗早产儿颅内出血后脑积水（PHH）的效果。方法：选取我院2012年5月至2014年6月收治的5例PHH早产儿,采用超声波引导侧脑室刺穿引流进行治疗,回顾性总结分析其治疗过程和临床特点。结果：5例患儿均成功进行穿刺引流,其中单侧引流4例,双侧引流1例,引流时间4～9 d,引流量5～55 m L/d。4例治疗有效,1例治疗无效后死亡,有效率80%。2例治疗过程中出现发热,经静脉给予抗生素治疗,2 d后发热症状好转并逐渐消失。治疗至引流液中WBC、RBC、PTA等生化指标正常时可考虑拔出引流管。结论：超声波引导侧脑室刺穿引流治疗早产儿PHH,具有穿刺次数少、放液量多、引流路径短等特点,有一定的临床应用价值。

Objective： To study clinical curative effect of ultrasound guided puncture drainage of lateral ventricle in the treatment of posthaemorrhagic hydrocephalus （PHH） in the premature infant. Methods： From May 2012 to June 2014, 5 cases of PHH premature infants were analyzed as clinical data, they were treated by ultrasound guided puncture drainage of lateral ventricle, retrospectivly summarized the clinical characteristics and clinical treatment process. Results： Five cases underwent successful puncture drainage, 4 cases were given unilateral drainage, 1 case was given bilateral drainage, drainage time 4 - 9 d, led traffic 5 - 55 mL/d. One case of treatment was invalid, the total effective rate was 80%. Two cases appeared fever in the process of treatment, given antibiotics by transvenous, fever symptoms improved and gradually disappear after two days treatments. Treatment stopped when the levels of WBC, RBC, PTA changed to the normal level. Conclusion： Ultrasound guided puncture drainage in the treatment of lateral ventricle puncture can put fluid amount more less, short the advantages of the drainage path, has a certain clinical value.