自发性脑室内出血50例临床分析  

50 CASES CLINICAL ANALYSIS OF SPONTANEUS INTRAVENTRICULAR HEMORRHAGE

作　　者：钟伟健[1] 蔡望青[1] 方向韶[2] 

机构地区：[1]中山大学附属第二医院神经外科,510120 [2]中山大学附属第二医院急诊科,510120

出　　处：《岭南急诊医学杂志》2004年第4期260-261,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的探讨自发性脑室内出血的治疗方法。方法50例Ⅰ～Ⅳ级的自发性脑室内出血病人根据病情分别采用保守治疗,侧脑室外引流术,开颅血肿清除术。结果50例患者中存活38例,存活率76%,疗效满意。结论对于Ⅰ、Ⅱ级病人清醒者,可单纯采用保守治疗;对于Ⅱ级病人意识已开始改变者,可予以锥孔外引流术;对于Ⅲ级病人已有明显意识改变或已出现早期脑疝表现者,应予手术清除血肿;而高龄伴多器官衰竭或晚期脑疝病人,治疗上倾向保守。OBJECTIVE:TO INVESTIGATE THE OPTIMUM TREATMENT OF INTRAVENTRICULAR HEMORRHAGE. METHODS:50 CASES OF SPONTANEUS INTRAVENTRICULAR HEMORRHAGE FROM GRADE ⅠTO Ⅳ WERE TREATED WITH MEDICAL MANAGEMENT,DRAINAGE OR CRANIOTOMY RESPECTIVELY. RESULTS:38 PATIENTS WERE SAVED AFTER TREATMENT, THE MORTALITY RATE WAS 24%. CONCLUSIONS: MEDICAL TREATMANT IS APPROPRIATE FOR PATIENTS WHO ARE CONSCIOUS, DRAINAGE IS APPROPRIATE FOR PATIENTS WHO ARE DETERIORATING, CRANIOTOMY IS APPROPRIATE PATIENTS WHO HAVE MAJOR FOCAL DEFICITS OR PRIMARY BRAIN HERNIATION. HOWEVER, FOR PATIENTS WITH SEVERE BRAIN HERNIATION OR ELDERLY PATIENTS WITH MULTIPLE ORGAN FAILURE, ONLY MEDICAL MANAGEMENT AND DRAINAGE ARE APPROPRIATE.

关 键 词：自发性脑室内出血 临床分析 治疗 侧脑室外引流术 开颅血肿清除术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]