双管置入引流治疗脑出血破入脑室86例临床分析

目的探讨采用锥颅、置入双管分别于侧脑室和脑内血肿中,尿激酶注入、溶解凝血块、引流等措施,治疗脑出血破入脑室的治疗手段及效果。方法对86例脑出血并且破入脑室患者的临床资料进行回顾性分析。该86例患者手术采用锥颅方式,将引流管分别放入侧脑室和脑内的血肿腔中,术后侧脑室和脑内血肿腔中多次注入尿激酶,溶解凝血块并经引流管将液态血排出颅外,同时给予脱水降颅压,静脉滴注抗生素等治疗措施。结果术后6例患者脑内血肿增多。82例患者侧脑室、脑内血肿完全消失。手术合并硬脑膜外血肿1例,合并颅内感染3例,脑脊液漏5例,植物生存2例,死亡2例。结论采用双管分别置入脑内血肿和侧脑室中,尿激酶注入、溶解血凝块并引流出颅外,能迅速降低颅内压,手术创伤小,是治疗脑出血破入脑室患者的有效方法。

Analysis on Patients of Cerebral Hemorrhage with Blood Flow into Cerebral Ventricle by Two Tubes Inserting and Draining: A Report of 86 Cases

Objective To approach the way and its effects by using skull stabber insert two tubes into lateral cerebral ventricle and intracranial hematom respectively,and inject urokinaset to resolve blood coagulum and draining to treat cerebral hemorrhage with blood flow into cerebral ventricle.Methods Retrospectively analysing the clinical data including 86 patients who are cerebral hemorrhage with blood flow into cerebral ventricle 86 of them using skull stabber,and insert two drainage tubes into lateral cerebral ventricle and intracranial hematoma respectively.And then inject enzymuria into haematoma cavern of lateral cerebral ventricle and intracalvarium to dissolve sludged blood and discharge the liquid blood out of intracalvarium by drainage tube,at the same time use the way of anhydration to depress the presure of brain and use antibiotics by intravenous drip infusion.Results After the operation,6 of them whose intracerebral hematoma is much than before,82 of the patients whose haematoma cavern of lateral cerebral ventricle and intracephalic haematoma is entirely dissappear after injecting urokinase by several times.One of them has the epidural hematoma complicating after operation,3 of them are intracranial infection,and 5 of them are of leakage of cerebrospinal fluid,2 of them are plant like survival,2 of them was dead.Conclusion Using two tubes into lateral cerebral ventricle and intracranial hematom respectively,and inject urokinase to resolve blood coagulum and drain out of the brain,which can degress intracranial pressure rapidly,the surgical trauma is miner and it is an effective method to treat cerebral hemorrhage with blood flow into cerebral ventricle.