高血压脑室铸型出血围手术期的综合治疗对策

摘要

目的：探讨高血压脑室铸型出血的综合治疗方法和临床疗效。方法：41例脑室铸型出血患者分别采用单侧或双侧侧脑室外引流术、脑室内尿激酶冲洗、腰穿腰大池置管持续外引流术和药物治疗,随访患者6个月。结果：双侧手术18例患者术后生存16例,术后功能性恢复按ADL分级法：ADL(恢复正常)8例,ADL(生活自理)4例,ADL(需人帮助)4例,死亡2例。单侧手术23例患者术后生存12例,术后功能性恢复按ADL分级法：ADL(恢复正常)2例,ADL(生活自理)5例,ADL(需人帮助)5例,死亡11例。结论：早期脑室外引流,加强脑脊液置换过程中引流管的管理,对围手术期并发症监护得当,可明显降低脑室铸型出血患者病死率。%Objective:Discussion on comprehensive treatment of hypertensive intraventricular hemorrhage of casting method and clinical effect.Methods:41 cases of intraventricular hemorrhage were treated with unilateral or bilateral ventricle drainage,intraventricular urokinase washout,lumbar puncture lumbar cistem tube continuous extermal drainage and drugtherapy,follow up of patients with 6 months. Results: 18 cases of bilateral operation 16 cases surrival after operation,functional recovery after grading by ADL method,return to normal in 8 cases,daily living without help 4 cases,daily living need someone to help in 4 cases,death in 2 cases. 23 cases of unilateral operation 12 cases surrival after operation,functional recovery after grading by ADL method,return to normal in 2.cases,daily living without help 5 cases,daily living need someone to help in 5 cases,death in 11cases.Conclusion:The mortality of patients with total cerebroventricular hemorrhage can be decreased by early externai drainage,the enhanced management during drainage period and the prevention of complications in the perioperative period.