外伤性蛛网膜下隙出血后慢性脑积水40例临床研究  

Clinical study of 40 cases with chronic hydrocephalus after traumatic subarachnoid hemorrhage

作　　者：魏雪峰[1] 杨柳 冯康[1] 

机构地区：[1]甘肃省天水市第一人民医院神经外科,741000 [2]计算机网络中心

出　　处：《中国医师进修杂志》2014年第13期17-19,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的总结外伤性蛛网膜下隙出血后慢性脑积水的临床特点及诊治方法。方法回顾性分析40例外伤性蛛网膜下隙出血后慢性脑积水患者的临床资料。结果8例经非手术治疗后好转，32例慢性脑积水患者经侧脑室腹腔分流术，3例术后出现分流管梗阻，腹腔、皮下、颅内感染，拔出分流装置后行二次手术。2例出现颅内出血，经保守治疗后出血吸收。40例患者格拉斯哥预后量表（GOS）评分良好32例，轻残5例，中残2例，重残1例。结论外伤性蛛网膜下隙出血后慢性脑积水应早诊早治，CT和MRI扫描是目前有效的确诊和鉴别手段，侧脑室腹腔分流术是疗效较好的治疗方式。Objective To discuss the clinical features and treatment methods of chronic hydrocephalus after traumatic subarachnoid hemorrhage. Methods A total of 40 cases of chronic hydrocephalus after traumatic subarachnoid hemorrhage were analyzed retrospectively. Results Eight cases improved after treatment of non-operation, the lateral ventricle external drainage was done in 32 cases of chronic hydrocephalus. Shunt tube obstruction occurred in 3 patients, with abdominal, subcutaneous and intracranial infection. The shunting operation device was pulled out and the 3 patients received operation for the second time. Two cases appeared intracranial hemorrhage, and the hemorrhage was absorbed after conservative treatment. Total Glasgow prognosis score was good in 32 cases, with mild disability in 5 cases, moderate disability in 2 cases and severe disability in 1 case. Conclusions Traumatic subarachnoid hemorrhage after chronic hydrocephalus should be early diagnosed and early treated, CT and MRI scan is the effective means to the diagnosis and differentiaion. The lateral ventricle external drainage is good method in treatment.

关 键 词：脑积水 蛛网膜下腔出血 外伤性 治疗 

分 类 号：R743.35[医药卫生—神经病学与精神病学]