尿激酶灌注术治疗脑室内出血的疗效及风险分析

目的 探讨双侧侧脑室外引流／尿激酶灌注治疗脑室内出血的临床疗效及风险。方法 34例脑室内出血患者，GCS〈8分者9例，GCS 8～10分者15例，GCS 11～15分者10例，均采用双侧脑室外引流／尿激酶灌注，引流、溶解脑室内血凝块，辅以扩张脑血管、营养脑细胞等综合治疗。结果 存活26例（76．47％）；再出血3例（8．8％）。死亡6例（17．6％），放弃治疗2例。存活的26例患者中4例因脑积水行脑室-腹腔分流术。结论 脑室内出血的治疗重点在于尽早清除脑室内血肿、疏通脑室梗阻，脑室外引流和尿激酶灌注是治疗脑室内出血的有效措施，但存在再出血的风险。

Effect and risk of drainage and urokinase perfusion in intraventricle hemorrhage

Objective To investigate the effect and risk of drainage and urokinase perfusion in intraventricle hemorrhage. Method 34 patients with intraventricle hemorrhage (GCS of 9 cases was lower than 8,GCS of 15 cases varied from 8 to 10,GCS of 10 cases fluctuated from 11 to 15), were undertakern external ventricular drainage and urokinase perfusion with the combined therapy of dilating cerebral vessels and brain cell nutrition. Results Among the 34 patients mentioned above 2 cases gave up treatment. The survival, rehaemorrhagia and death rate were 76.4% (26/34), 8.8%(3/34) and 17.6%(6/34) respectively. 4 survived cases were undertakern ventriculo-peritoneal shunt owing to dropsy of brain. Conclusion Ventricle drainage and urokinase perfusion are an effective method for the treatment of intraventricle hemorrhage with the risk of rehaemorrhagia.