重症脑室出血的综合治疗

目的:探讨重症脑室出血的综合治疗方法,以期降低其死亡率。方法:收集重症脑室出血患者(GCS评分<7分)17例,早期采用双侧脑室交替或同时引流和尿激酶灌注,并腰椎蛛网膜下腔持续引流,以及改善脑微循环等综合措施进行治疗。结果:17例中,存活12例(70.59％),其中1例因脑积水行脑室-腹腔分流术。5例死亡(29.41％)。结论:尽早疏通脑室梗阻,改善脑脊液循环与脑微循环是重症脑室出血救治成功的关键,采用脑室引流、尿激酶灌注和腰椎蛛网膜下腔持续引流等综合措施治疗重症脑室出血,是一种安全、可行、有效的方法,能显著提高其预后。

Comprehensive Treatment of Severe Intraventricular Hemorrhage

Objective: To discuss the comprehensive treatment of severe intraventricular hemorrhage (SIVH) in order to reduce the mortality rate. Methods: 17 patients with SIVH (GCS score<7) were treated by early bilateral in- traventricular drainage and perfusing of urokinase simultaneously or alternatively,and limbar subarachno il continuous drainage. Results: Of the 17 patients, 12 survived (70.59%) in which only 1 case suffered from delayed hydrocephalus and accepted a ventriculo peritoneal shunt operation,and 5 died (29.41%). Conclusion:It was the key to the successful treatment of SIVH to eliminate the intraventricular obstruction,impro ve the CSF flow and brain microcirculation. The combined intraventricular draina ge with perfusion of urokinase and lumbar subarachnoil continuous drainage was a rela- tively safe,feasible and effective method to treat SIVH, and could greatly i mprove its prognosis.