23例脑出血致急性梗阻性脑积水行脑室外引流治疗的效果分析  

Effect analysis of external ventricular drainage in treatment of 23 patients with acute obstructive hydrocephalus induced by cerebral hemorrhage

作　　者：蔡正华[1] 王学建[1] 

机构地区：[1]南通大学第二附属医院神经外科,江苏南通226001

出　　处：《实用临床医药杂志》2015年第9期25-27,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨出血性脑卒中导致急性梗阻性脑积水行脑室外引流的手术方法及时机。方法回顾性分析23例急性梗阻性脑积水并行脑室外引流术的患者临床资料。结果急性梗阻性脑积水23例:高血压脑出血并破入脑室致脑积水17例,其中14例行单侧脑室额角外引流术(左侧5例,右侧9例),3例行双侧侧脑室额角外引流,术后存活16例,1例因并发肺部感染死亡,需二次行脑室腹腔分流术4例;血管畸形脑出血4例均行单侧脑室外引流(左侧1例,右侧2例),1例行双侧引流,存活3例,1例因感染最终器官衰竭死亡,其中1例需二次脑室腹腔分流术;脑梗死致梗阻性脑积水2例,行右侧侧脑室额角穿刺引流,1例存活,另1例因脑损伤死亡。结论对于出血性脑卒中导致的急性梗阻性脑积水,脑室外引流术是有效的治疗方法。Objective To explore operation method and time of external ventricular drainage for patients with acute obstructive hydrocephalus induced by hemorrhagic apoplexy. Methods Clinical materials of 23 acute obstructive hydrocephalus patients with external ventricular drainage were analyzed retrospectively. Results In the 23 patients with acute obstructive hydrocephalus,17 patients had hydrocephalus due to hypertensive cerebral hemorrhage broke into ventricles of brain,14 of them were treated by external drainage of frontal horn of the brain ventricle in one side（5 left sides and 9right sides）,3 cases were treated by two sides. Of the 14 cases,16 patients survived after operation,one case died due to pulmonary infection,and 4 cases had to accept ventriculo-peritoneal shunt for hydrocephalus. Vascular malformation hemorrhage was observed in 4 cases,and they were treated with external drainage of frontal horn of the brain ventricle in one side（1 left side and 2 right sides）. One case was treated by two sides. Of the 4 patients,3 cases survived after operation,one case died due to organ failure,and one case had to accept ventriculo-peritoneal shunt for hydrocephalus. Cerebral infarction was observed in 2 cases,and they were treated by external drainage of frontal horn of the brain ventricle in right side. One case survived after operation,and one case died due to brain injury. Conclusion For patients with acute obstructive hydrocephalus induced by hemorrhagic apoplexy,external ventricular drainage is an effective treatment method.

关 键 词：急性梗阻性脑积水 脑室外引流术 脑室腹腔分流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]