摘要
目的:探讨脑室穿刺引流并脑脊液置换术治疗重型脑室出血的最佳手术时机。方法:48例重型脑室出血患者随机分为超早期组(A组)、急性期组(B组)和亚急性期组(C组),按照不同的时间点行双侧脑室穿刺引流术后,分别在入选时和治疗后1个月末进行改良Barthel指数评分,治疗满1个月时记录患者的基本痊愈率、总有效率、病死率和再出血发生率。结果:治疗后A、B组Barthel指数评分、基本痊愈率、总有效率均高于C组,而死亡率低于C组(P<0.01);A、B两组的基本痊愈率、总有效率、死亡率无明显差异(P>0.05)。A、B和C3组的再出血发生率无明显不同(P>0.05)。结论:重型脑室出血患者在24h内行脑室穿刺引流并脑脊液置换术可以有效地降低病死率、致残率,提高治愈率和日常生活能力。
Objective：To explore the optimal operation time for brain ventricular drainage combined with cerebrospinal fluid replacement in treatment of severe intraventricular hemorrhage. Methods： Fourty-eight cases with severe intraventricular hemorrhage undergone bilateral brain ventricular draingae combined with cerebrospinal fluid replacement in different times were divided into superearly stage group （group A）, acute stage group （group B） and subacute stage group （group C）. Revised harthel index was recorded and evaluated in patients in three groups before and after treatment. Total effective rate, recovery rate, mortality and rehemorrhage incidence were assessed one month after treatment. Results： The harthel index,total effective rate and recovery rate in group A and B were higher than those in group C,and mortality rate was lower than that in group C （P〈0.01）. There were no significant differences in total effective rate, recovery rate and mortality between group A and B （P〉0. 05）. No significant differences in rehemorrhage incidence among three groups （P〉0. 05）. Conclusion： Brain ventricular drainage combined with cerebrospinal fluid replacement within 24 hours after onset of the disease can decrease mortality, increase cure rate and ability of daily activity in patients with severe intraventricular hemorrhage.
出处
《内科急危重症杂志》
2007年第1期12-14,共3页
Journal of Critical Care In Internal Medicine
基金
济宁市医药卫生科技攻关项目(编号:200409003)
关键词
重型脑室出血
微创手术
手术时机
Severe intraventricular hemorrhage Microinvasive operation Operation opportunity
