重症脑室出血的临床救治

目的 探讨重症脑室出血的救治方法，以期降低重症脑室出血的死亡率。方法 早期采用双侧脑室交替或同时尿激酶灌注引流及早期改善脑血液循环等综合措施治疗。结果 本组救治50例重症脑室出血病人(GRAEB评分＞5分)，存活率72％(36／50)，死亡率28％(14／50)，36例存活患中5例因脑积水行脑室—腹腔分流术。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，脑室引流、尿激酶灌注治疗重症脑室出血是一种安全、可行、有效的方法。

Clinical Experience of Management for Severe Intraventricular Hemorrhage

Objective To summarize the therapeutic experience of severe intraventicular hemorrhage(SIVH).Methods Fifty patients with SIVH(Graeb score>5),including3cases of ruptured aneurysm and1ruptured AVM,were treated by bilateral intraventricular drainage and infusing of urokinase simultaneously or alternatively within3days after onset of symptoms.Result Of the50patients,36,in whom only5cases suffered from delayed hydrocephalus and accepted a ventriculoperitoneal shunt operation,showed excellent or good outcome and14died.Conclusions It is the key to the success of treatment of SIVH to canal the intraventicular obstruction and improve the CSF flow and periventicular microcirculation.The combined ventricular drainage with infusion of urokinase is a relatively easy and safe method of treating SIVH and can greatly improve its prognosis.