侧脑室引流联合双针腰穿脑脊液置换治疗脑室出血

目的:比较侧脑室引流联合双针腰穿脑脊液置换治疗和单纯侧脑室引流治疗脑室出血的疗效。方法:94例脑室出血患者分别采用侧脑室引流加尿激酶灌注联合双针腰穿脑脊液置换治疗(治疗组,46例)或侧脑室穿刺引流加尿激酶灌注治疗(对照组,48例),比较二组的存活率、死亡率和脑积水发生率。结果:治疗组死亡6例(13%),而对照组死亡15例(31%),二者的疗效差异有统计学意义(P<0.05)。术后随访半年,治疗组中并发交通性脑积水1例,对照组则为7例。结论:侧脑室引流联合双针腰穿脑脊液置换治疗脑室出血的疗效优于单纯侧脑室引流。

Lateral Ventricle Drainage and Cerebrospinal Fluid Exchange by Two-needle Lumbar Puncture in Intraventricular Hemorrhage

Objective: To compare the therapeutic efficacy of lateral ventricle drainage with or without cerebrospinal fluid exchange by two-needle lumbar puncture in intraventricular hemorrhage (IVH). Methods: Ninety-four patients with IVH underwent lateral ventricle drainage alone (control group, n=48) or with cerebrospinal fluid exchange by two-needle lumbar puncture (treatment group, n=46), and the survival rate, mortality and prevalence of hydrocephaly in both groups were compared. Results: The mortality was 13% in treatment group, and 31% in control group, and there was a statistical difference in the therapeutic efficacy between two groups (P < 0.05). During six monthes follow-up, communicating hydrocephalus occurred in 1 and 7 cases in treatment group and control group, respectively. Conclusion: The effect of lateral ventricle drainage and cerebrospinal fluid exchange by two-needle lumbar puncture is superior to that of lateral ventricle drainage alone on the treatment of IVH.