颅内压监测下侧脑室穿刺脑室外引流术治疗脑室内出血的临床研究  

External ventricular drainage through lateral ventricle puncture under intracranial pressure monitoring for treatment of intraventricular hemorrhage

作　　者：徐茂法[1] 张立新[1] 杨子健[1] 王树新[1] 宋清安[1] 许旭亮 王智恒[1] 顾燕忠 兰吴春 钱玲华 董晓巧[2] 

机构地区：[1]杭州市余杭区第二人民医院神经外科,311121 [2]杭州市第一人民医院神经外科

出　　处：《浙江医学》2015年第8期664-666,670,共4页Zhejiang Medical Journal

摘　　要：目的探讨颅内压监测下侧脑室穿刺脑室外引流术对脑室内出血(IVH)患者的治疗效果。方法回顾性分析126例IVH患者,比较颅内压监测下侧脑室穿刺脑室外引流术治疗组(简称颅内压监测组)与传统脑室外引流术治疗组(简称传统手术组)患者术后再出血发生率、甘露醇使用量、急性肾损伤发生率、颅内感染发生率及术后3个月格拉斯哥预后评分(GOS。结果颅内压监测组患者术后再出血发生率、甘露醇使用量、急性肾损伤发生率及颅内感染发生率均显著低于传统手术组(P<0.05 or 0.01);术后3个月颅内压监测组患者GOS分值明显高于传统手术组(P<0.05)。结论颅内压监测下侧脑室穿刺脑室外引流术治疗IVH,可显著减少患者术后并发症的发生,明显改善临床预后,值得临床推广应用。Objective To investigate efficacy of external ventricular drainage through lateral ventricle puncture under in- tracranial pressure monitoring for intraventricular hemorrhage （IVH）. Methods The clinical data of 126 patients with IVH, who underwent external ventricular drainage through lateral ventricle puncture under intracranial pressure monitoring （treatment group）, were retrospectively analyzed. Rate of postoperative recurrent bleeding, dose of mannitol, rate of renal impairment, rate of intracranial infection and 3-month Glasgow outcome scale score were documented and compared with those underwent tradi- tional external ventricular drainage（control group）. Results Postoperative rate of recurrent bleeding, dose of mannitol, rate of re- nal impairment and rate of intracranial infection were markedly lower （P〈0.05 or 0.01） and postoperative 3-month Glasgow out- come scale score was significantly higher（P〈0.05） in treatment group than those in control group. Conclusion External ventric- ular drainage through lateral ventricle puncture under intracranial pressure monitoring for treatment of IVH can markedly decrease the occurrence of postoperative complications and significantly improve clinical outcomes.

关 键 词：颅内压监测 脑室外引流术 脑室内出血 

分 类 号：R651.1[医药卫生—外科学]