外科治疗自发性脑室出血患儿的疗效分析

Surgical efficacy of spontaneous intraventricular hemorrhage in infants and young children

目的探讨婴幼儿自发性脑室出血的外科治疗方法及疗效。方法回顾性分析20例自发性脑室出血患儿的临床资料,根据具体病情分别进行腰椎穿刺术、腰大池引流术、脑室外引流术和脑室联合腰大池引流术。所有患儿随访6个月至2年,观察其疗效。结果2例行反复腰椎穿刺术、5例行持续腰大池引流术者,均痊愈;持续行脑室外引流术者10例,7例痊愈,3例好转;行脑室联合腰大池引流术者3例,2例痊愈,1例好转;本组中无死亡病例。结论婴幼儿脑室出血应及时进行外科治疗,具体手术方式应依据出血部位及出血量来决定,如治疗及时、术式适宜,则预后良好。

Objective To explore the surgical treatment and efficacy of spontaneous intraventricular hemorrhage in infants and young children. Methods Retrospective analysis was performed for 20 cases with spontaneous intraventricular hemorrhage.The different operations were selected according to specific diseases:(1)Lumbar puncture;(2)Lumbar cistern drainage;(3)External ventricular drainage;(4)External ventricle drainage plus lumbar cistern drainage.The follow-up period was from 6 months to 2 years. Results Two cases with repeated lumbar puncture and 5 cases with lumbar cistern drainage were cured.Among 10 cases with external ventricular drainage,they were cured ( n =7) and improved significantly ( n =3).Among 3 cases with external ventricle drainage plus lumbar cistern drainage,they were cured ( n =2) and improved significantly ( n =1).There was no case of mortality. Conclusion Infants and young children with intraventricular hemorrhage should be operated timely without delay.The choice of surgical operation depends on hemorrhagic site and amount of hemorrhage.Most patients have a good prognosis under proper treatment and appropriate operation.