脑室外引流联合脑室内纤溶治疗高血压脑室内出血的疗效观察

Observation on the Curative Effect of Extraventricular Drainage Combined with Intracerebroventricular Fibrolysis in the Treatment of Hypertensive Intraventricular Hemorrhage

【目的】探讨脑室外引流联合纤溶治疗高血压脑室内出血患者的临床疗效。【方法】回顾性分析本院收治的195例高血压脑室内出血患者的临床资料.根据治疗方式不同将其分为观察组(脑室外引流联合脑室内纤溶治疗,n=98)和对照组(脑室外引流治疗组n=97)。比较两组患者手术情况及两组患者治疗疗效。观察高血压脑室内出血患者术后预后不良发生率。【结果】观察组预后不良发生率低于对照组,差异有统计学意义(χ^2=13.387,P<0.001).观察组患者ADL分级Ⅰ-Ⅲ级76例(77.55%)高于对照组的66例(68.04%),差异有统计学意义(χ^2=-2.375,P=0.018<0.05)。观察组住院时间、脑室外引流拔出时间、术后残余血肿量明显短于对照组,差异有统计学意义(P<0.05)。观察组患者术后迟发性脑积水及颅内感染率显著低于对照组,差异无统计学意义(χ^2=3.327,P=0.072;χ^2=0.423,P=0.515)。【结论】脑室外引流联合纤溶治疗高血压脑室内出血患者可改善患者日常生活能力,缩短住院时间,对改善患者预后有重要意义。

[Objective]To observe the incidence of poor prognosis after hypertensive intraventricular hemorrhage. I Met hods jThe clinical data of 195 patients with hypertensive intraventricular hemorrhage treated in our hospital were analyzed retrospectively. According to the different treatment methods, they were divided into observation group (extraventricular drainage combined with intraventricular fibrinolysis, n =98) and control group (extra ve ntricular drainage treatment group, n =97). The surgical conditions and the therapeutic effects of the two groups were compared, and the incidence of poor prognosis in patients with hypertensive intraventricular hemorrhage was observed.!ResultsjThe incidence of poor prognosis in the observation group was lower than that in the control group (χ^2 = 13.387, P <0.001). The ADL grade of 76 patients (77.55%) in the observation group was higher than that of 66 patients (68.04%) in the control group (χ^2 =- 2.375. P =0.018 < 0.05). The hospitalization time, the extraction time of ventricular drainage and the amount of residual hematoma in the observation group were significantly shorter than those in the control group ( P <0.05). The incidence of delayed hydrocephalus and intracranial infection in the observation group was significantly lower than that in the control group (χ^2 = 3.327 . P =0.072;χ^2= 0.423 , P =0.515).[ Conclusion]Extraventricular drainage combined with fibrinolysis can improve the daily living ability of patients with hypertensive intraventricular hemorrhage, shorten hospitalization time, and improve the prognosis of patients with important significance.