开颅手术联合脑室穿刺外引流治疗重型脑室出血的临床应用

Evaluation of the Clinical Value of Ventriculopuncture Combind with Surgery in Treatment of Massive Ventricular Hemorrhage

目的 探讨开颅手术联合脑室穿刺外引流治疗重型脑室出血的临床价值。方法 以前额或顶后及枕下中线入路手术联合脑室外引流治疗三、四脑室铸型的脑室出血患者 18例 ,观察其治疗效果。结果 可在直视下彻底清除三、四脑室内血肿。 18例中存活 14例 (健康生存 7例 ,偏瘫 4例 ,植物生存状态 3例 ) ,死亡 4例 (2 2 .2 % ) ,低于传统单一手术 (30 % )。结论 手术联合脑室穿刺外引流治疗重型脑室出血 ,可以明显改善患者的预后 ,降低病死率 ,减少并发症 ,具有较好的临床价值。

Objective To evaluate the clinical value of ventriculopunctured combine with surgery in treatment of massive ventricular hemorrhage. Methods Eighteen patients with masive ventricular hemorrhage were treated by ventriculopuncture combind with surgery, by frontal, posterior parietal or suboccipital approach. The results were observed and the clinical features, operation approaches and prognosis were discussed. Results The hematoma in ventricles could be completely removed by direct surgery. In this group, 14 patients survived, among whom, 7 recovered to normal, 4 remained hemiplegia, 3 were in vegetative state. 4 patients died with a mortality rate of 22.2% which was lower than that of surgery only (30%). Conclusions Ventriculopuncture combind with surgery is effective in treating massive ventricular hemorrhage. It could improve the prognosis, reduce the .mortality and complication.