腰大池灌注林格氏液加脑室外引流治疗脑室出血的实验研究

目的 探讨腰大池恒压灌注林格氏液加侧脑室外引流治疗脑室内出血的安全性、可行性及疗效。方法 选用纯种比格犬10条做成脑室内出血的模型，模型建立后4h开始治疗，实验组5条，以2．96kPa(1kPa＝7．5mm Hg)的压力经腰大池灌注林格氏液，同时行侧脑室外引流；对照组5条，用侧脑室外引流的方法。两组在治疗过程中均严格监测颅内压(ICP)及生命体征，记录引流量及灌注量，经12h的治疗后处死动物并收集脑室内全部残余积血，比较两组标本含铁血红蛋白的吸光度值。结果 两组动物从模型建立后至处死前生命体征平稳颅内压波动不太。经12h的治疗，实验组的引流量明显多于对照组(P＜0．05)，实验组脑内残余积血量明显少于对照组，两组差异有显著性(P＜0．05)。结论 以2．96kPa的压力恒压灌注林格氏液于腰大池内，同时行侧脑室外引流治疗脑室内出血的方法安全可行，能更快地消除脑室内积血。

Ringer''''s solution pressure perfusion through lumbar cistern and lateral ventricle extradrainage treating intraventricular hemorrhage

Objective To explore the reliability,feasibility and curative effect of Ringer's solution pressure perfusion through lumbar cistern and lateral ventricle extradrainage in the treatment of intraventricular hemorrage.Methods Ten pure breed dogs were chosen to develop intraventricular hemorrhage model.Four h after establishment of model,treatment was given.Five dogs in experimental group were subjected to Ringer's solution through lumbar cistern under 2.96 kPa pressure in combination of lateral ventricle extradrainage.Five dogs in control group underwent routine lateral ventricle extradrainage only.Both intracranial pressure and vital signs were strictly monitored during the treatment in two groups.Drainage flow and perfusion volume were recorded.The animals were killed 12 h after treatment and whole intraventricular hematocele was collected through urokinase resolution.Photo densitometry of hemoglobinosiderin in two groups was compared by Spectrophotometric instrument after samples were diluted 10 times.Results Of the animals in two groups from time of model development to death,intracranial pressure didn't fluctuate and vital signs were stable.Drainage flow in experimental group was obviously more than that of control group ( P <0.05).Intraventricular hematocele volume in experimental group was obviously less than that of control group ( P <0.05).Conclusion The method of Ringer's solution pressure perfusion through lumbar cistern in combination lateral ventricle extradrainage treating intraventricular hemorrhage is reliable and feasible,and can more quickly clean up intraventricular hematocele.