脑室外引流并用尿激酶灌洗治疗高血压脑-脑室出血  

Treating Hypertensive Cerebral Hemorrhage and Breaking into Ventricle with Ventricular Eextra-drainage and Urokinase Lavage

作　　者：王穗雯 何绮微 钟伟健[2] 谭平国[2] 

机构地区：[1]广州市芳村区医院,510370 [2]中山大学附属第二医院

出　　处：《岭南急诊医学杂志》2002年第1期28-30,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:观察脑室外引流并用尿激酶灌洗治疗高血压脑出血破入脑室的疗效。方法:分析30例高血压脑出血破入脑室的病人的资料。无中线脑室系统积血及梗阻的单侧脑室出血(Ⅰ型)18例;有中线脑室系统积血伴脑脊液循环梗阻的单侧脑室铸型出血(Ⅱ型)8例,全脑室系统铸型出血(Ⅲ型)4例。入院后均经侧脑室额角插入内径3mm的硅胶引流管,用尿激酶灌洗、引流4～14天,平均8.2天。结果:30例病人9例死亡,死亡率为30％。术后并发症有肺部感染、应激性溃疡、水盐糖代谢紊乱、肾功能不全、顽固性颅内高压、脑梗塞等。死亡多因并发症引起。21例术后随访6个月以上,生活能力(activity daily living, ADL):Ⅰ15例、Ⅱ3例、Ⅲ2例、Ⅳ1例。结论:脑室外引流并用尿激酶灌洗术,方法简易,损伤小。是高血压脑-脑室出血一种重要的治疗方法,死亡率低,恢复良好。Objective: To value the effect of ventricular extra-drainage and urokinase lavage in treating hypertensive cerebral hemorrhage and breaking into ventricle. Methods: To analysis the data of 30 patients who suffered from hypertensive cerebral hemorrhage and breaking into ventricle. Type Ⅰ (18 cases), no middle ventricle hematocele and obstructive single lateral ventricular hemorrhage; type Ⅱ (8 cases), middle ventricle hematocele and single lateral ventricular obstructed and cast; type Ⅲ(4 cases) all ventricels cast. All the patients were drilled and put the drainage duct trains frontal corn of lateral ventricle、lavage、drain. The time ranges from 4 to14 days, mean 8.2 days. Results: 9 died, the mortality ratio 30%. Complications included infection of the lung; Cushing's ulcer; metabolismic imbalance of the water, eletrolyte and glucose; renal dysfunction、intractable increased intracranial pressure, cerebral infarction. Death mostly result from complication. 21 patients were followed up for more than 6 monthes. Activity daily living(ADL): Ⅰ 15 cases、Ⅱ 3 cases、Ⅲ 2 cases, Ⅳ 1 case. Conclusions: Ventricular extra-drainage and urokinase lavage is an important method for treating hypertensive cerebral hemorrhage and breaking into ventricle with ventricular. It is simple, minial-hurt, low mortality and good prognosis.

关 键 词：脑室外引流 尿激酶 脑室出血 高血压 

分 类 号：R651[医药卫生—外科学]