早期腰池持续引流联合侧脑室内尿激酶灌注在中重度自发性脑室内出血治疗中的应用(附34例临床分析)  

Early continuous lumbar drainage joint with lateral intraventricular infusion of urokinase in the application of the relation to intraventricular hemorrhage(report of 34 cases)

作　　者：刘金龙[1] 张高健 揭家广 赵子森 蒋友田 张燕辉[1] 于世龙[1] 姚一搏[1] 邢红伟[1] 

机构地区：[1]安徽省临泉县人民医院神经外科,临泉236400

出　　处：《立体定向和功能性神经外科杂志》2015年第6期347-349,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨早期腰池持续引流联合侧脑室外引流及尿激酶灌注在脑室内出血治疗中的效果。方法连续纳入我院神经外科2013年6月~2015年6月收住的34例中重度脑室内出血患者,在脑室外引流尿激酶灌注治疗的基础上并腰池置管持续性引流,行颅脑CT动态观察,根据脑室系统积血引流情况拔除引流管。结果腰池引流时间7~21天,平均14天,脑室引流时间7~14天,平均10.5天;并发症：脑疝3例,颅内感染4例,颅内积气6例,脑积水3例;恢复情况：日常生活能力（ADL）I级8例（23.5%）、II级12例（35.3%）、III级9例（26.5%）、IV级3例（8.9%）、V级1例（2.9%）、死亡1例（2.9%）。结论脑室内尿激酶灌注并腰大池置管持续性引流,有利于尽早清除脑室内的积血,缩短脑室外引流时间,减少颅内感染发生,降低因脑积水造成继发损伤和再次手术的几率,提高抢救治疗的成功率,改善患者预后。Objective To investigate the effect of the early lumbar continuous drainage combined with lateral intraventricular infusion of urokinase in IVH.Methods 34 patients with Intraventricular hemorrhage（IVH）in neurosurgery of our hospital from June 2013 to June 2015,accept the treatment of ventricle and lumbar drainage large pool drainage,dynamic observation of craniocerebral CT,and remove the drainage tube according to the results of inspection.ResultsLumbar drainage time 7~21days,average 14 days,ventricular drainage time 7~14days,average10.5days;Complications：hernia 3cases,intracranial infection 4cases,intracranial gas 6cases,hydrocephalus 3cases;Recovery：ADL I level 8cases（23.5%）,II level 12cases（35.3%）,III level 9cases（26.5%）,IV level3cases（8.9%）,V level 1case（2.9%）,1patient died（2.9%）.Conclusion Intraventricular infusion of urokinase and lumbar catheter drainage continuity will be helping our patients to remove intraventricular hemorrhage as soon as possible,shorten ventricular drainage time,reduce intracranial infection and secondary injury due to hydrocephalus and probability of reoperation to improve the success rate of rescue therapy,and improve patient＇s prognosis.

关 键 词：腰池引流 脑室出血 颅内感染 脑积水 

分 类 号：R743.34[医药卫生—神经病学与精神病学]