单侧、双侧脑室外置管引流治疗高血压性脑出血破入脑室的优劣差异

The Advantages and Disadvantages of Unilateral and Bilateral Ventricle Drainage in the Treatment of Hypertensive Cerebral Hemorrhage

目的:探讨分析单侧、双侧脑室行外置管引流治疗高血压性脑出血后破入脑室的优劣差异。方法:选择本院收治的140例高血压性脑出血破入脑室患者作为研究对象,行双侧脑室置管引流治疗70例(双侧组),行单侧脑室置管引流治疗70例(单侧组),所有患者均处理脑内血肿,在术后均行尿激酶冲洗。比较两组患者引流治疗时间、引流管通畅率、手术穿刺损伤率及术后脑室感染率。结果:当患者有脑室扩大时,双侧脑室外置管引流组的引流治疗时间为(9.0±2.4)d,短于单侧外置管引流组的(12.1±2.8)d,双侧脑室外置管引流组的引流管通畅率为87.5%,明显高于单侧外置管引流组的73.5%,比较差异均有统计学意义(P<0.05)。而当患者无脑室扩大时,单、双侧引流治疗时间及引流管通畅率比较差异均无统计学意义(P>0.05);单侧、双侧脑室外置管引流术造成的穿刺损伤率分别为4.3%、5.7%,比较差异均无统计学意义(P>0.05),治疗期间两组患者均未发生脑室感染事件。结论:单侧、双侧脑室外置管引流治疗高血压性脑出血破入脑室均安全有效,当患者有脑室扩张时双侧脑室行外置管引流治疗效果好于单侧,当患者无脑室扩张时,单、双侧脑室行外置管引流效果均较好,无显著差别。

Objective： To study and analyze the advantages and disadvantages of unilateral and bilateral ventricular drainage in the treatment of hypertensive cerebral hemorrhage broken.Method： 140 patients with hypertensive cerebral hemorrhage in our hospital were selected as the research objects, 70 patients received the bilateral ventricu]ar drainage （ bilateral group ）, another 70 patients received the unilateral ventricular drainage （ unilateral group ） .All patients were cleared ventricle hematoma, the drainage tube were flushed with urokinase after surgery.Drainage treatment time, drainage tube patency rate, surgical puncture injury rate and postoperative ventricular infection rate of two groups were compared.Result： When hypertensive cerebral hemorrhage patients with ventricular expansion, the drainage treatment time in bilateral group was （ 9.0 ± 2.4 ） d, shorter than unilateral group of（ 12.1 ± 2.8 ） d, the drainage tube patency rate in bilateral group was 87.5% greatly higher than the unilateral group of 73.5%, the differences were statistically significant （ P〈0.05 ） .While hypertensive cerebral hemorrhage patients without ventricular expansion, compared the treatment time and drainage tube patency rate of two groups, the differences were not statistically significant （ P〈0.05 ） .Unilateral and bilateral ventricular puncture injury rate were respectively 4.3% and 5.7%, the difference was not statistically significant （ P〈0.05 ） . All the patients didn＇t have ventricular infection.Conclusion： Unilateral and bilateral ventricular drainage in the treatment of hypertensive cerebral hemorrhage are safe and effective.While patients with ventricular enlargement, bilateral ventricular drainage treatment has better effect than unilateral ventricular drainage treatment.As patients without ventricular enlargement, the two treatment both have good efficacy, the difference is not statistically significant.