颅内压监测下侧脑室外引流治疗丘脑出血破入脑室  

External ventricular drainage for the treatment of thalamic hemorrhage ruptured into ventricles under intracranial pressure monitoring

作　　者：徐伟[1] 邓德旺[1] 李桂心[1] 黄立平[1] 陈立峰[1] 

机构地区：[1]福建医科大学教学医院福鼎市医院神经外科,福建福鼎355200

出　　处：《中华神经外科疾病研究杂志》2012年第5期413-417,共5页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨颅内压监测下侧脑室外引流治疗高血压性丘脑出血破入脑室的疗效。方法收集60例高血压性丘脑出血破入脑室患者的临床资料,无颅内压监测组32例,未应用颅内压监测,颅内压监测组28例,加用颅内压持续监测,比较两组的再出血率、并发症发生率及总体预后。结果颅内压监测组与无颅内压监测组相比,再出血率及并发症发生率明显降低,死亡率降低,恢复良好率提高,均有显著性差异。结论颅内压监测下侧脑室外引流治疗高血压性丘脑出血破入脑室可以更加直观、更准确地了解患者颅内压力的变化情况,根据颅内压控制引流速度、合理应用脱水剂及控制血压、保证有效满意的脑灌注压,进而降低了再出血率、减少了并发症,改善了患者的预后,安全性更高、疗效更好。Objective To study the efficacy of external ventricular drainage under intracranial pressure monitoring（ICPM） for the treatment of hypertensive thalamic hemorrhage ruptured into ventricles.Methods A total of 60 patients with hypertensive thalamic hemorrhage ruptured into ventricles were enrolled and assigned into the ICPM group（28 patients） and non-ICPM group（32 patients）.The rebleeding rate,complications and prognosis after treatment were compared between ICPM group and non-ICPM group.Results Compared with the non-ICPM group,the rebleeding rate,complications and mortality were significant lower in ICPM group and the favorable-recovery rate in ICPM group was also higher.Conclusion External ventricular drainage under ICPM is found to reflect accurately the changes of intracranial pressure and facilitate the flexible control of drainage speed,the rational use of dehydrants and blood control,all of which have contributed to a satisfactory brain perfusion pressure.As a result,it reduces the rebleeding and complication rate and improves the prognosis with a better efficacy and safety.

关 键 词：颅内压 监测 丘脑出血 侧脑室引流 

分 类 号：R743.34[医药卫生—神经病学与精神病学]