改良式侧脑室联合腰大池持续交替引流在脑室出血中的应用(1)
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【摘要】 目的 探讨改良式侧脑室联合腰大池持续交替引流术治疗脑室出血的临床疗效。 方法 将98例脑室出血患者随机分成2组，改良组(50例)采用改良式侧脑室联合腰大池持续交替引流术，传统组(48例)采用单纯侧脑室引流或结合腰椎穿刺术，比较两组的临床疗效。 结果 改良组脑室内积血清除速度明显快于传统组(P<0.01)。改良组6例(12.0%)发生梗阻性脑积水，4例(8.0%)死亡；传统组13例(27.1%)发生梗阻性脑积水，9例(18.8%)死亡，两组均无颅内感染病例；改良组疗效明显优于传统组(P<0.05)。 结论 改良式侧脑室联合腰大池持续交替引流术治疗脑室出血可明显降低病死率和伤残率，减少并发症和后遗症，改善预后，优于传统技术和方法。
【关键词】
侧脑室；腰大池置管；交替引流；脑室出血；尿激酶
Treatment of intraventricular hemorrhage by improved external ventricular drainage combined with lumbar cisternal drainage
WANG Zhiyong, FANG Luxiong, AI Changmiao,et al.
Department of Neurosurgery,FuGang Pepoles Hospital,Qingyuan 511600,China
【Abstract】 Objective To study the clinical results of improved external ventricular drainage combined with lumbar cisternal drainage in treating intraventricular hemorrhage. Methods Nintyeight cases of intraventricular hemorrhage were divided into two groups randomly. One group(called improved group)cases were treated by persistent interchange external ventricular drainage combined with lumbar cisternal drainage,and the other group(called traditionary group)cases with external ventricular drainage or combined with lumbar puncture.All the clinical results were studied retrospectively.Results In improved group, 6 cases(12.0%) had obstructive hydrocephalus and 4 cases(8.0%) died, compared with 13 cases(27.1%) and 9 cases(18.8%) in traditonary group respectively.In all cases, no intracranial infection was observed. Totally, the clinicl efficacy of improved group cases was significantly better than that of the traditionary one(P<0.05).Conclusion Treating intraventricular hemorrhage by improved external ventricular drainage combined with lumbar cisternal drainage, compared to traditionary methods, is associoated with decreaesed morbility and mortality,and can reduct complications and improve prognosis.
【Key words】
Lateral ventricular; Lumbar cisternal drainage; Interchange drainage; Intraventricular hemorrhage; Urokinase
脑室出血是临床常见多发病，其病情重，致死率、致残率高，后遗症多。探讨该病的有效治疗方法一直是神经外科医师所思考的问题。我们选择2010年1月至2011年6月经CT确诊的脑室出血患者98例，随机分为改良组50例和传统组48例进行对照研究 ......
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