YL-1型针侧脑室穿刺及腰椎穿刺术持续外引流系统治疗脑室铸型出血的疗效观察  

Therapeutic efficacy observation for YL-1 type puncture needle entry into lateral ventricles adding continuous external lumbar drainage in the treatment of ventricular hemorrhage casting

作　　者：何木良 宁锦龙 黄剑峰[1] 钟向球 易椿钧 植汉兴 骆志明[1] 

机构地区：[1]广西中医药大学附属贺州医院神经外科,广西桂林542899

出　　处：《吉林医学》2015年第7期1286-1288,共3页Jilin Medical Journal

基　　金：贺州市科学研究与技术开发计划[项目编号:贺科能1101002Y]

摘　　要：目的:观察应用YL-1型针侧脑室穿刺及腰椎穿刺术持续外引流系统治疗脑室铸型出血的临床疗效。方法:将40例确诊为脑室铸型出血的患者随机分为对照组(A组)、治疗组(B组)两组,每组各20例,A组予单纯的微创YL-1型针侧脑室穿刺引流术,术后给予尿激酶液化血肿,脑脊液置换治疗等治疗,B组予对照组治疗的基础上增加腰穿持续外引流系统治疗。比较两组患者清除脑室内积血的时间快慢,探讨YL-1型针侧脑室穿刺及腰穿持续外引流系统治疗脑室铸型出血的作用机制。结果:3 d内脑室积血清除率对照组(A组)为0例(0.0%),治疗组(B组)为6例(30%);7 d后脑室积血清除率对照组(A组)14例(70%),治疗组(B组)1例(5.0%)。死亡率A组为7例(35%),B组为3例(15%)。术后6个月GOS比较,对照组(A组)及治疗组(B组)(疗效良好)分别为6例(30%)、12例(60%)。结论:该方法可以明显降低中重型脑室铸型出血患者的死亡率,迅速清除脑室系统及蛛网膜下腔的积血,加快脑脊液循环正常化,提高生存患者的生活质量,该方法有推广价值。Objective To observe the therapeutic efficacy of YL-1 type puncture needle entry into lateral ventricles adding continuous external lumbar drainage in ventricular hemorrhage casting. Method 40 cases of patients with ventricular hemorrhage casting were randomly divided into control group（ group A） and treatment group（ group B）. Each group had 20 cases. Group A was treated with YL-1 type of minimally invasive needle drainage entry into lateral ventricle,and postoperative given urokinase to liquefy hematoma and cerebrospinal fluid replacement therapy. Group B was given the additional lumbar continuous drainage system in the basis of group A. The rate of intraventricular hematoma clearance was compared in the two groups. Results The intraventricular hematoma clearance rate within 3 days was 6 cases（ 30%）in the treatment group（ B group） compared with 0 cases（ 0%） in the control group（ A group）. The clearance rate of the control group（ A group） after 7 days was 14 cases（ 70%）,while 1 case（ 5%） in the treatment group（ B group）. The mortality rate of A group was 7 cases（ 35%） compared with 3 cases（ 15%） in B group. 6 months after operation,GOS was respectively 6 cases（ 30%） and 12 cases（ 60%） in the control group and treatment group（ good efficacy）. Conclusion The method can obviously reduce the mortality of severe intraventricular hemorrhage patients,quickly remove the hematocele in the ventricular system,and accelerate the subarachnoid cerebrospinal fluid circulation,and improve the quality of patients＇ life.

关 键 词：脑室铸型出血 YL-1型穿刺针 外引流系统 交替液化 

分 类 号：R651.1[医药卫生—外科学]