两种手术方法治疗重症脑室铸型血肿的对照研究  

Controlled study of two operative ways for severe intraventricular casting mould hematoma

作　　者：周杰[1] 李凯[1] 董涛[1] 赵全华[1] 车万民[1] 

机构地区：[1]中国中医科学院望京医院神经外科,北京100102

出　　处：《中华脑科疾病与康复杂志（电子版）》2011年第1期43-45,共3页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：北京市科委重大研究课题(D0905004040311)

摘　　要：目的探讨重症脑室内铸型血肿两种手术方法的疗效。方法回顾性分析65例经治重症脑室内铸型血肿患者临床资料,将其分为两组,A组(治疗组)33例,在脑室穿刺尿激酶灌注引流常规治疗的基础上,开颅清除四脑室铸型血肿;B组(对照组)32例予以脑室穿刺尿激酶灌注引流常规治疗。按格拉斯哥预后分级法(GOS)于6个月后对治疗结果进行评定。结果 A组总有效率为66.67%,B组总有效率为34.37%,两组总有效率比较差异有统计学意义(P<0.05)。结论尽早疏通脑室梗阻,改善脑脊液循环与脑微循环是重症脑室内铸型血肿救治成功的关键。在脑室引流并尿激酶灌注基础上,开颅清除四脑室铸型血肿对患者加速促醒以及提高生存质量均有重要的临床意义。Objective To explore the effectiveness of 2 operative ways for severe casting mould intraventricular hematoma and look for the optimal method. Methods The clinical data of 65 patients were retrospectively analyzed. The patients were divided into A（treatment） and B（control） groups. In group A （n = 33） , hematoma evacuation of the fourth ventricle through craniotomy was performed in addition to ventricular drainage and infusion of urokinase, and in group B（ n = 32） , only ventricular drainage and infusion of urokinase were used. Results The 2 groups showed significant difference in clinical efficacy. Conclusions In the cases of severe casting mould intraventricular hematoma. It is paramount to remove the intraventrieular obstruction and promote the CSF flow as soon as possible, and thus improve cerebral microcirculation. Evacuation of the fourth ventricle hematoma in addition to concomitant ventricle drainage and urokinase infusion has significant efficacy in promoting patients＇ consciousness recover and improving the life quality.

关 键 词：脑室内血肿 脑室引流 尿激酶 手术治疗 

分 类 号：R651.1[医药卫生—外科学]