侧脑室穿刺置管于三脑室联合尿激酶治疗脑室出血的临床疗效观察

Clinical efficacy observation of lateral ventricle puncture and catheterization in the third ventricle combined with urokinase in the treatment of intraventricular hemorrhage

目的评价经侧脑室穿刺置管于三脑室联合尿激酶治疗脑室出血的临床疗效。方法回顾性分析2018年1月至2020年1月我院收治的62例脑室出血患者,根据手术方式不同分为三脑室置管组30例与常规脑室穿刺组32例,两组患者术后注射尿激酶8万U溶解血肿,比较两组术后颅内感染率、死亡率、再出血率、血肿溶通时间,术前、出院前及术后3个月Barthel指数评分。结果三脑室置管组术后血肿溶通时间明显短于常规脑室穿刺组(P<0.01);出院前及术后3个月Bathel指数评分均显著高于常规脑室穿刺组,差异有统计学意义(P<0.01);两组患者颅内感染率,再出血率及死亡率差异均无统计学意义(P>0.05)。结论经侧脑室穿刺置管于三脑室联合尿激酶能有效溶解三脑室、中脑导水管、四脑室血肿,改善患者预后。

Objective To evaluate the clinical efficacy of lateral ventricle puncture and catheterization in the third ventricle combined with urokinase in the treatment of intraventricular hemorrhage(IVH).Methods Sixty-two patients with IVH treated in our hospital from January 2018 to January 2020 were retrospectively analyzed.According to different surgical methods,the patients were divided into a third ventriclecatheterization group(n=30)and a conventional ventricle puncture group(n=32).Both groups were injected with 80,000 U urokinase to dissolve hematomaafter operation.The postoperative rate of intracranial infection,mortality rate,rebleeding rate,hematoma lysis time,and Barthel index scores before operation,before discharge and after 3 months of surgery were compared between the two groups.Results The postoperative lysis time of the hematoma in the third ventricle catheterization group was significantly shorter than that of the conventional ventriclepuncture group(P<0.01).The Bathel scores before discharge and after 3 months of operation in the third ventricle catheterization group were significantly higher than those in the conventional ventricle puncture group(P<0.01).There was no significant difference in intracranial infection rate,rebleeding rate and mortality rate between the two groups(P>0.05).Conclusion The catheter placed in the third ventricle through lateral ventricle puncture combined with urokinase can effectively dissolve the hematoma in the third ventricle,midbrain aqueduct,and the fourth ventricle.It can improve the prognosis of the patients.