Ommaya囊联合侧脑室外引流治疗脑室内出血

目的探讨脑室内出血(IVH)的治疗方法并评价其临床疗效。方法 40例IVH病例随机分为改良组及传统组。改良组选择在出血相对较多的一侧常规行侧脑室额角穿刺外引流;而在出血相对较少的一侧额角置入Ommaya囊后行囊腔穿刺外引流。脑室外引流5~7 d后,改为仅Ommaya囊穿刺外引流。传统组则行双侧侧脑室普通外引流,5~7 d后结合腰大池置管持续引流血性脑脊液治疗。比较两组患者迟发性脑积水、颅内感染发生率及预后情况等。结果两组迟发性脑积水、颅内感染发生率及预后(ADL分级)比较差异有统计学意义(P0.05),表明改良组疗效明显优于传统组。结论该项改良技术安全可靠、损伤小、恢复快,能大大降低病死率和伤残率,减少并发症和后遗症,改善预后,优于传统方法。

Ommaya reservoir combined with external ventricular drainage for intraventricular hemorrhage

Objective To study the treatment of intraventricular hemorrhage （ IVH） and evaluate its therapeutic effects.Methods 40 cases with IVH were divided into the improved group and traditional group randomly .In the improved group , puncture of lateral ventricle anterior hom and external ventricular drainage was performed in the side of ventricular with more blood for 5 to 7 days.While the other side was treated by continuous Ommaya reservoir drainage .In the traditional group , bilateral external ventricular drainage was performed , combining with continued lumbar cerebrospinal fluid drainage 5 to 7 days later as tradition . The prognosis and incidences of delayed hydrocephalus and intracranial infection were compared between two groups .Results The prognosis （ ADL degree ） and incidences of delayed hydrocephalus and intracranial infection in the improved group were much better than the traditional group, which had statistical significance （P〈0.05）.Conclusion The improved treatment was superior to the traditional method which decreased damage , promoted recover , reduced complication and sequela , improved prognosis ,lessened mortality ratio and disability rate and was safe and reliable .