侧脑室穿刺加腰穿引流术治疗脑室铸型出血疗效观察  

Lateral ventricle puncture plus lumbar drainage for treatment of intraventricular hemorrhage of casting form

作　　者：侯黎明[1] 裴敬[1] 

机构地区：[1]合江县人民医院,四川合江646200

出　　处：《现代医药卫生》2010年第13期1941-1943,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨脑室铸型出血临床治疗方法。方法:对我院1999年11月～2007年11月治疗的96例脑室铸型出血临床资料进行回顾性分析。结果:治疗组血肿平均清除时间为5.3d,对照组血肿清除时间7.6d,两组差异有统计学意义(P<0.05);治疗组2d神志清楚26例,占48.15%,对照组2d神志清楚11例,占26.19%,两组差异有统计学意义(P<0.05);1个月后GCS评分,治疗组优良20例,轻残19例,重残4例,死亡11例;对照组优良8例,轻残14例,重残10例,死亡10例。以优良和轻残视为有效,治疗组有效率72.22%,对照组为52.38%,两组比较差异有统计学意义(P<0.05);治疗组发生梗阻性脑积水13例,占24.07%,对照组为19例,占45.24%,两组差异有统计学意义(P<0.05)。结论:侧脑室穿刺加腰穿引流术治疗脑室铸型出血是一种安全、有效、可行的治疗措施,值得临床推广运用。Objective：To explore the clinical treatment of intraventricular hemorrhage of cast form.Methods：A total of 95 patients visited in our hospital from November 1999 to November 2009 were divided into test group（n=54）and control group（n=42）.The control group were treated with simple drainage of lateral ventricle,and the test group were treated with external drainage of lateral ventricle plus continuous lumbar drainage.The duration of disturbance of consciousness,hematoma removal time,GCS score and complications were sta-tistically analyzed to evaluate the therapeutic effect of intraventricular hemorrhage.Results：The average clearance time of hematoma was 5.3 d in the test group,however it was 7.6 d in the control group,the difference between two groups was statistically significant（P0.05）;26 patients were conscious in 2 d,accounting for 48.15% in the test group,and only 11 patients were conscious in 2 d,accounting for 26.19% in the control group,the difference was statistically significant too（P0.05）.There were 20 cases with fine,19 cases with light residual,4 cases with severe disability,and 11 cases with death in test group;compared with the test group,there were 8 cases with fine,14 cases with light residual,10 cases with severe disability,10 cases with death in the control group.According to GCS score after one month,the validness as fine and light residues accounted for 72.22% in the test group and 52.38% in the control group,the difference was obviously significant（P0.05）.13 patients were complicated by obstructive hydrocephalus in the test group,which was less than 19 pa-tients in the control group.Conclusion：The lateral ventricle puncture plus lumbar drainage for treating intraventricular hemorrhage is a safe,effective and feasible treatment measure and worth popularizing in clinic.

关 键 词：脑室铸型出血 侧脑室穿刺 腰穿引流 

分 类 号：R5[医药卫生—内科学]