Intraventricular hemorrhage(IVH)is a dangerous acute cerebrovascular disease.The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage.In recent years,more and more studies ha...Intraventricular hemorrhage(IVH)is a dangerous acute cerebrovascular disease.The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage.In recent years,more and more studies have shown that timely clearance of intraventricular hematoma is closely related to good prognosis.The advantages of surgical intervention in patient management are impressive.This article briefly reviews the positive advances in the surgical treatment of IVH such as external ventricular drainage(EVD)combined with intraventricular fibrinolysis(IVF)and continuous lumbar cistern drainage(LCD),as well as their safety and efficacy,especially the remarkable role of neuroendoscopy in the removal of intraventricular hematomas.展开更多
目的通過總結鏡湖醫院神經外科治療的腦室內血腫患者的資料,明確r-tPA治療腦室內血腫的价值及併發症發生率。方法收集2009年1月~2017年1月期間鏡湖醫院神經外科治療的121例腦室內血腫患者中,其中使用r-t P A治療的有56例,單純腦室外引...目的通過總結鏡湖醫院神經外科治療的腦室內血腫患者的資料,明確r-tPA治療腦室內血腫的价值及併發症發生率。方法收集2009年1月~2017年1月期間鏡湖醫院神經外科治療的121例腦室內血腫患者中,其中使用r-t P A治療的有56例,單純腦室外引流或開顱血腫清除+置管引流(稱“對照組”)的65例,分別收集兩組病人的GCS評分,mRS評分、GOS評分,腦室內血腫清除的情況及各種併發症發生率相關進行總結。結果r-tPA注射組中,4/56(7%)例病人的死亡,對照組中,11/65(16.9%)例死亡。腦室內血腫清除72h G r a e b評分r-t P A注射組為3.00±1.92,對照組為9.00±2.78。G O S評分為1~2分患者在r-t P A注射組為28/56(50%),對照組為21/65(32.3%)。r-t P A注射組患者並發新鮮出血6/56例(10.7%),對照組術後並發新鮮出血的病人1/65例(1.5%)。r-t P A注射組注射r-t P A後顱內壓升高6/56例(10.7%)、併發心律失常4/56例(7.1%),併發引流管堵塞1/56例(1.8%),對照組引流管堵塞7/65例(10.8%)。注射r-t P A治療結束後出現腦積水需要行腦室腹腔分流的9/56例(16.1%)。而對照組有27/65例(41.5%)。結論經腦室外引流管注射r-tPA治療腦室內積血是一種有效的治療措施,能加快腦室內血腫的溶解排除,減少引流管堵塞,降低病人腦積水併發症。然而部份病人在開顱血腫清除、去除顱骨減壓或引流管放置在血腫腔內均增加繼發出血風險。同時需控制注射藥物的液體總量及注射溶液的溫度,避免I C P升高或並發心率失常、抽搐等併發症。展开更多
文摘Intraventricular hemorrhage(IVH)is a dangerous acute cerebrovascular disease.The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage.In recent years,more and more studies have shown that timely clearance of intraventricular hematoma is closely related to good prognosis.The advantages of surgical intervention in patient management are impressive.This article briefly reviews the positive advances in the surgical treatment of IVH such as external ventricular drainage(EVD)combined with intraventricular fibrinolysis(IVF)and continuous lumbar cistern drainage(LCD),as well as their safety and efficacy,especially the remarkable role of neuroendoscopy in the removal of intraventricular hematomas.
文摘目的通過總結鏡湖醫院神經外科治療的腦室內血腫患者的資料,明確r-tPA治療腦室內血腫的价值及併發症發生率。方法收集2009年1月~2017年1月期間鏡湖醫院神經外科治療的121例腦室內血腫患者中,其中使用r-t P A治療的有56例,單純腦室外引流或開顱血腫清除+置管引流(稱“對照組”)的65例,分別收集兩組病人的GCS評分,mRS評分、GOS評分,腦室內血腫清除的情況及各種併發症發生率相關進行總結。結果r-tPA注射組中,4/56(7%)例病人的死亡,對照組中,11/65(16.9%)例死亡。腦室內血腫清除72h G r a e b評分r-t P A注射組為3.00±1.92,對照組為9.00±2.78。G O S評分為1~2分患者在r-t P A注射組為28/56(50%),對照組為21/65(32.3%)。r-t P A注射組患者並發新鮮出血6/56例(10.7%),對照組術後並發新鮮出血的病人1/65例(1.5%)。r-t P A注射組注射r-t P A後顱內壓升高6/56例(10.7%)、併發心律失常4/56例(7.1%),併發引流管堵塞1/56例(1.8%),對照組引流管堵塞7/65例(10.8%)。注射r-t P A治療結束後出現腦積水需要行腦室腹腔分流的9/56例(16.1%)。而對照組有27/65例(41.5%)。結論經腦室外引流管注射r-tPA治療腦室內積血是一種有效的治療措施,能加快腦室內血腫的溶解排除,減少引流管堵塞,降低病人腦積水併發症。然而部份病人在開顱血腫清除、去除顱骨減壓或引流管放置在血腫腔內均增加繼發出血風險。同時需控制注射藥物的液體總量及注射溶液的溫度,避免I C P升高或並發心率失常、抽搐等併發症。
